Generic drugs are more expensive in Ireland than the EU Although we are taking more generic drugs, it had not led to any savings for the State or the cash-paying patient. THE PRESCRIPTION OF generic drugs has almost doubled since 2010 to reach 50 per cent of the market, however, it had not led to any substantial savings for the State or the cash-paying patient as had expected. The ESRI report ‘Ireland: Pharmaceutical Prices, Prescribing Practices and Usage of Generics in a Comparative Context’ looked at pharmaceutical prices, the use of non-brand drugs and the prescribing practices of doctors. It found that in comparison to other EU countries, in-patent drugs are higher in Ireland, while off-patent drugs are lower. Most notable, the ESRI report found that non-branded drugs are more expensive in Ireland than in other EU countries. Prescribers in Ireland have a choice between different medicines within the same therapeutic sub-group, they tend to select the most expensive. While prescribers in the UK prescribe the least expensive medicine within the same therapeutic sub-groups. The Health (Pricing and Medical Goods) Act 2013, which was signed into law in May, holds out the possibility of radically changing the way in which pharmaceutical prices are set in Ireland as pharmacists will now be able to select a lower-priced medicine than that prescribed for the patient by the doctor. The ESRI also highlights the increasing use of ‘patient access agreements’ as an alternative mechanism for setting pharmaceutical prices. Under them, prices are negotiated between the State and manufactures but kept confidential. The increasing use of this mechanism should prompt a wider discussion about transparency and how the benefits of new medicines should be evaluated. Report welcomed The Minister for Health Dr James Reilly and Minister of State Mr Alex White welcomed the report. Minister Reilly said he is “confident that the steps we have taken and are currently taking will have a significant impact on the cost of medicines in this country”. The State has introduced a series of reforms in recent years to reduce pharmaceutical prices and expenditure and this programme of reform is ongoing. Price reductions of the order of 30 per cent per item reimbursed have been achieved between 2009 and 2013; the average cost per item reimbursed is now running at 2001/2002 levels. Minister White said that the Health (Pricing and Supply of Medical Goods) Act 2013 which came into operation last Monday “will further promote price competition, a greater use of generics and deliver lower medicine prices for the taxpayer and for patients”. Under this legislation reference pricing will be introduced later this year which will ensure that generic prices will fall towards European norms. I believe this legislation will allow us to achieve significant cost reductions on generic medicines compared to market leaders. The HSE’s Preferred Medicines Initiative alone has the potential to save money for the cash-paying patient and an estimated €15million for the taxpayer.” Responding to the finding in the ESRI report on prescribing practices, Minister Reilly called on General Practitioners to be conscious of the cost of medicines when prescribing for their patients. White said while he is not telling doctors how to prescribe for their patients: I would ask them to consider doing so in a more cost effective way, such as by prescribing generically, where appropriate, including the international non-proprietary name (INN) on prescriptions. This will achieve the same result for patients”.