‘It’s €2.65 versus €71.97…That’s Just Extraordinary’

at

90155036Screen Shot 2014-07-28 at 11.27.08

A table (above) showing comparative generic drug prices between Ireland and Britain, from yesterday’s Sunday Business Post

Susan Mitchell, the health correspondent with the Sunday Business Post, spoke to Rachel English on Morning Ireland this morning in relation to the price of generic medicines in Ireland.

Rachel English: “Tell us about some of the price differences between here and the UK because there are some quite staggering differences.”

Susan Mitchell: “Some of them are absolutely colossal, you’re right. We have one which is called, the generic name of this drug is Olanzapine and the original brand would be called Zyprexa which is what a lot of patients would know it as. The British price is €2.65, the Irish price is €71.97, so it’s just absolutely massive.”

English: “It’s €2.65 versus €71.97, that’s just extraordinary…”

Mitchell: “It is extraordinary. Now, to be fair, that was the biggest variation we’ve seen but many of the others were also, were also huge. There was another psychiatric drug called [Anti-depressant] Seroquel, the brand name I’m not even going to attempt to pronounce it but the Irish price is €34.80, in other words what the HSE is paying. The NHS is paying €2.90. And there were many, many other examples for a variety of different medicines, medicines to treat breast cancer, statins, which are used by hundreds of thousands of patients, so these are adding up to an enormous amount of money for the State and the taxpayer.”

English: “For years, we were told that the wider use of generic drugs would be key to bringing down health costs, so why are the prices of these drugs so high?”

Mitchell: “I really cannot answer that. The HSE has brought down the prices. They have. The reference price which they’ve now set for all of these medicines and they’ve set prices for about 20 medicines over the past year is certainly lower than what it was. But the differentials between here and the UK remain absolutely colossal. I don’t know why that is. The HSE says they have to be cognisant of things like security and supply, we’re a smaller market. There is, I know that some people would, you know, theorise that we have to keep big pharma in the country happy because they employ so many people. A lot of other people dispute that because they say that nobody in pharma would expect variations of this magnitude, it’s more to do with incompetence more than anything else. I really can’t explain why the variations are so huge.”

English: “So, what’s being done to tackle this problem?”

Mitchell: “Well reference pricing was suppose to tackle this problem and that’s what’s so disappointing about this – certainly from taxpayers’ perspectives and, indeed, patient groups. Because reference pricing was supposed to bring our prices down and bring us into line with the rest of Europe. And that was what former health minister James Reilly actually said. He said that, under reference pricing, you know the time, or the variations between here and the UK would end. Unfortunately they haven’t.”

English: “Have the pharmaceutical companies had anything to say about this?”

Mitchell: Very little, they’ve said very little. Other than the fact that prices have come down, and indeed they have. They also would say that we’re a much smaller market. And, another important point and I think that is a valid point is that we have had a very, very small number or the competition for generic market here in Ireland has been quite small in the past. So there aren’t as many companies competing for businesses. So that possibly is a factor but as people suggested to me, why don’t we bypass all the generic companies here and go straight to the UK and buy our medicines from them?”

English: “And at the moment, how is the price decided? Who does the deal for the State?”

Mitchell: “The HSE does this. So effectively what happens is the Irish Medicines Board groups a bunch of medicines in the same bracket. So these would all be off-patent and generic medicines. So if you take something like Atorvastatin, the original brand was Lipitor. When that comes off patent, the Irish Medicines Board bunches all of the various different Atorvastatins in a particular group. And the HSE then goes in and sets what is called a reference price. And this reference price is the amount that the HSE will reimburse pharmacists for that medicine. If someone with a medical card wants the original branded product, or a more expensive variation, they must pay the difference themselves, but this is what the HSE is paying.”

English: “You’ve been writing about this for several years now. Do you see that any attempt is being made to try and address the problems?”

Mitchell: “There is an attempt being made but I feel it’s inadequate. I don’t think that anybody can even try to justify variations of this magnitude. I think there’s something seriously wrong. And if the HSE is finding that pharma companies aren’t playing ball, well then it should come out and say this, and say this publicly and arguably maybe look to bypass some of these smaller companies in this market and go direct to the UK and purchase our medicines there.”

Listen back in full here

Pic: Susan Mitchell

32 thoughts on “‘It’s €2.65 versus €71.97…That’s Just Extraordinary’

  1. H

    I’m probably missing a lot of the detail but why not just import the cheaper versions from the UK?

    1. H

      PS What’s with not being able to buy codeine over the counter in Ireland? Some of us can’t take ibuprofen or aspirin and paracetamol is useless

        1. Kdoc

          So are cigarettes, alcohol, chocolate, gambling sex etc. etc. On occasions, over many years I have had to take codeine, thankfully infrequently, and I never became addicted to it. I believe addiction, to any substance or behaviour, has more to do with the psychology of the individual than anything to do with what they ingest. There is a psychological phenomenon known as addictive personality.

      1. rosie

        as sidewinder said…
        fun fact: the reason you like codeine is because it’s converted to morphine in 1st pass metabolism (though there are many lacking the pathway).
        and everyone likes morphine…

        1. H

          I knew it was addictive, did not know it was morphine, explains the ‘don’t take it for more than 3 days’ lecture whenever I buy it. (Which is every couple of months or so)

    2. scottser

      ..or even make them here and supply them gratis. but that would annoy the big pharma companies, i guess.

    1. scottser

      it comes from having bugger all for so long that when we do get a taste we’d sell our own grannies for a chai latte and a tuscany three-bean salad.

  2. CousinJack

    Whose getting the kick backs in the HSE?

    Easy way to solve this, have HSE agree with NHS to include Ireland in their tenderers, after all NHS includes NI so no significant supply chain issues. Even if HSE has to pay a premium to NHS to cover variation in demand and currency fluctuation would be a lot cheaper. after all adding 4.5 million to 67 million is not even 10% increase.

    1. Odis

      You’re right, its about kickbacks isn’t it. What’s the difficulty with buying from the NHS, is it a “green jersey” issue?

  3. Haroo von Haroo

    A doctor told me that many years ago that the hse did a deal with clonmel pharmaceuticals (who make most of the generics in Ireland) that they would get 90% of the cost of the brand name drug

  4. Odis

    Its to do with markets eh?
    Not that I know where the “Drugs Market” is in Ireland. But if say, a product is cheaper in Argos, than Tesco. I go the extra couple of miles to Argos.
    Surely, it would make sense for the HSE to send someone over on the boat to England, with a Transit van.

  5. Snoouchthebigoouch

    If the HSE were anyway competent this would be easily solved, but because the civil servants who approve this want the easiest life possible no effort is made to solve this.

    What’s needed is the name of the individuals in the HSE who approve these prices so they can be sent P45s for gross incompetence. Unfortunately the unions won’t allow this.

  6. SOMK

    According to the Irish Pharmaceutical Healthcare Association our ex-factory costs are linked to those in “Austria, Belgium, Denmark, Finland, France, Germany, The Netherlands, and The UK.”

    If so, does that mean that it’s the wholesalers and pharmacists who are adding the cost, or are they being very loose with their definition of the word “linked”?

    http://www.ipha.ie/alist/price-of-medicines.aspx

    “An important aspect in the development of the sector, which has helped to significantly boost its contribution to the Irish economy, has been the success of the sector in diversifying the nature of its investment in Ireland from the original bulk active plants to higher value activities. The maintenance of a culture of support for innovation is significant to the success of such a move up the value chain.”

    The value chain!

    “Ireland is now the largest net exporter of pharmaceuticals in the world and using the broader pharmachem measure, exports were worth €55.1 billion in 2011, accounting for over 50% of all exports from the country.”

    We make a lot of food here too, yet we’ve the fifth highest food costs in Europe (though it has gotten relatively cheaper since 2008 when we were the 2nd most extensive in Europe) and that’s without charging VAT on food (which all the European countries ahead of us on the list do, Denmark for example charge 25% VAT on food).

    1. Clampers Outside!

      They’re linked alright. They keep the prices here high so they can maintain higher prices across Europe. Apparently Ireland is a ‘benchmark’ market…. I read this, or something to that effect, a while back.

      If I find a link I’ll post it.

      It’s a bullsh8t excuse for the high prices, of course.

      1. Snoouchthebigoouch

        I’ve heard that about the pharma companies agreeing a price with the HSE and using that as a benchmark across Europe.

  7. Kolmo

    Certain well connected individuals profiteering at the expense (!!) of the Irish people, same ‘ol story. Some PR shill is going to waffle about how things are so different here than elsewhere, fudge and confuse the issue and back to business..Politicians seem to be just a buffer between the people and big business..the citizen is almost the enemy, just like 100 years ago, 150 years ago…nothing changes…

  8. Hicksonian

    I spent €23 today on an antibiotic that cost €12.95 in 2011- Klacid Forte. The generic one cost €22 so I didn’t bother changing. It seems that whatever interests are being served in this distorted market are still protected with gilt edged guarantees of nothing to see here, move on.

  9. johnny

    It has fupp all to do with big pharma, our market is so small they couldn’t give a fupp what we charge for our drugs here as it will have no impact on their bottom line.

    Where cheap drugs do have an effect is on one of our indigenous industries – the local pharmacist. Up until recently you could send your scrip to the UK and the cheap generics would be sent back by return post. The pharmaceutical society lobbied like fcuk for a clampdown, and found it under obscure medicines board legislation suggesting that having your scrip filled in another EU state and sent back amounted to importation of controlled drugs which required a licence. You can still physically fill your scrip in Newry etc but again the pharmacists down here are trying to stop this by claiming you still need an import licence to bring them back home with you over the boarder.

    The only people who gain from high drug prices here are Pharmacists and the revenue commissioners.

  10. Odis

    We are told, by our politicians, that the only way forward for the HSE is the closing of Accident and Emergency Departments, Maternity Units and Mental Health Units (because they are “unsafe”).

    But my guess is that this information about money that can be saved on drugs, will be ignored.

    It would be nice if Mr (Breath of fresh air) Leo Varadkar, could make some attempt to explain what would appear to be huge managerial incompetence or corruption in his department.

  11. Kolmo

    Box of Ibuprofen in Co.Cavan 5.79 (Virginia) – same thing in Co.Fermanagh 1.29 (Euro1.62) (Superdrug, Enniskillen)

  12. wikky

    It would be interesting to see what countries with a relatively similar size population to ours like Norway or Croatia are paying for these types of drugs, surely it would be a more reasonable comparison.

    1. DizzyDoris

      Why should the size of the population determine the cost of prescription drugs?
      I’m pretty sure two of the reasons are Pharmacist’s wages and greedy landlords. The answer is simple, head North. The Customs really have better things to be doing than tackling sick people buying medication.

  13. Chesse

    The cost of medication, and healthcare in general, in Ireland was one of the main reasons I emigrated.

    I used to have to pay 145€ monthly, on the drug payment scheme, to receive my monthly supply of pills. Add to this the 50€ cost of having your GP write you the script in the first place. This is all not counting the cost of private health insurance for yearly check ups, trips to the emergency room etc. – that’s obviously a lot more and totally necessary if you have a serious lifelong condition.

    I live in Germany now and pay 70€ a month for my health insurance – it doesn’t cover everything (I.e.: dental), but its pretty damn good – no waiting months to get seen by a specialist, no waiting 20 hours to get seen in a&e. my daily, lifesaving pills now cost me less than 20€ for a 3 months supply. To see your GP costs around 10€ per quarter.

    I understand the differences between the countries and so on, but this is healthcare were talking about. The HSE and the government have to sort it out – its been a shambles for decades now. When the NHS is looking better than your health system, you know we have problems.

Comments are closed.