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 Header Item Land and Conveyancing Law Reform Bill 2015: First Stage (Continued)
 Header Item Health (Pricing and Supply of Medical Goods) (Amendment) Bill 2015: First Stage
 Header Item Suicide Prevention Authority Bill 2015: First Stage

Wednesday, 9 December 2015

Dáil Éireann Debate
Vol. 900 No. 1

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  1 o’clock

Health (Pricing and Supply of Medical Goods) (Amendment) Bill 2015: First Stage

Deputy Sean Fleming: Information on Seán Fleming Zoom on Seán Fleming I move:

That leave be granted to introduce a Bill entitled an Act to amend the Health (Pricing and Supply of Medical Goods) Act 2013 to allow interchangeability between biologic and biosimilar medical goods.

I am pleased to introduce this short Bill, which I hope can reduce the large bill of up to €2 billion that we face each year for medicines in our health services. The Department of Health and the HSE have failed to get value for money on behalf of the taxpayer. At a recent meeting of the Committee of Public Accounts, it was confirmed that the renegotiation of the deal between the Government and the Irish Pharmaceutical Healthcare Association, IPHA, which was due to expire at the end of October, had not proceeded because the Government side was putting together for the first time a full, centralised national database of all medicines being purchased on behalf of the taxpayer. The State purchases medicines for use in acute hospitals and community settings and for prescription by general practitioners, GPs. It is an indictment of the HSE and the Department that they have not had all of this information in one place to date. It is essential that we do so in order to reduce the cost of medicines and improve the Government's negotiating position in respect of these contracts.

  The proposed Bill would amend the Health (Pricing and Supply of Medical Goods) Act 2013 in two ways. First, it would allow consultants and doctors to choose biosimilar drugs, or biologics, instead of existing medicines. Biologics are medicines that are made by or derived from a biological source, such as a bacterium or yeast. They can consist of relatively small molecules such as insulin or more complex ones. They are more affordable and are the norm across Europe, but Ireland has refused to adopt them. My proposed Bill would allow for patients to be switched, where appropriate, from existing medicines to more affordable, but equally effective, biosimilars. This is not allowed under the current legislation.

  Second, the Bill would allow doctors and consultants to prescribe all newly diagnosed patients with generic, more affordable medicines instead of the branded, expensive medicines that we have currently. For some conditions, doctors and consultants continue to prescribe the more expensive branded medicines for newly diagnosed patients. The 2013 Act provides an exemption allowing the prescriber not to substitute a branded medicine for a generic one in particular circumstances. We all agree with this, but while generic substitution is not recommended for patients on existing treatment regimes, there is no reason new patients seeking treatment for the first time cannot be given more affordable generic alternatives. That is what the Bill proposes to do. Prescribers should move to generics when there is no good medical reason not to do so.

  The proposed measures have the potential to deliver savings for the taxpayer. Savings from the use of biosimilar medicines are in the region of €40 million per annum, while savings from the use of generic medicines can amount to €10 million, giving a total saving of €50 million every year. We need to do this, as that €50 million could be put to better use in the health service.

  The national procurement office should be given the task of managing this contract. I have called for that year in, year out and we have included it in our annual budget submissions. I am delighted that a national database is being put in place for the first time. Shame on the HSE and the Department of Health for entering into an agreement with the companies when they did not even know the full extent of what they were purchasing.

  Recently, I met representatives of the IPHA and the Healthcare Enterprise Alliance regarding the cost of drugs. They contacted me after I raised this general issue at the Committee of Public Accounts and I was happy to meet them. The Health Products Regulatory Authority, HPRA, is responsible for the establishment, maintenance and publication of a list of interchangeable medical products. This list allows the HPRA to group medicines that are deemed interchangeable with one another. Doctors can then prescribe and pharmacists dispense medicines within that group. Everything that I have suggested would require the HPRA's normal approval of medicines. There would be no question of a doctor or consultant prescribing a medicine on the basis that he or she believed it had done well in Europe. It would have to be approved in Ireland by our statutory agency.

  My Bill provides for the removal of section 5(7)(d) of the 2013 Act, which prohibits the substitution of biologic and biosimilar medicines for medicinal products. Some people will not get this, but it is happening in Europe, which is far ahead of us. These medicines should only be used where they are deemed equally effective and there is a saving to the taxpayer. I am pleased to commend the Bill to the House.

An Ceann Comhairle: Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl Is the Bill opposed?

Minister for Public Expenditure and Reform (Deputy Brendan Howlin): Information on Brendan Howlin Zoom on Brendan Howlin No.

  Question put and agreed to.

An Ceann Comhairle: Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl Since this is a Private Members' Bill, Second Stage must, under Standing Orders, be taken in Private Members' time.

Deputy Sean Fleming: Information on Seán Fleming Zoom on Seán Fleming I move: "That the Bill be taken in Private Members' time."

  Question put and agreed to.

Suicide Prevention Authority Bill 2015: First Stage

Deputy Derek Keating: Information on Derek Keating Zoom on Derek Keating I move:

That leave be granted to introduce a Bill entitled an Act to provide for the establishment of a body to be known in the Irish language as an tÚdarás um Chosc ar Fhéinmharú or in the English language as the Suicide Prevention Authority, to define its functions and to provide for connected matters.

I am pleased to have the opportunity to sponsor this Bill and I commend it to the House for its First Reading.

  Suicide remains the single greatest preventable cause of death, with upwards of ten people in Ireland dying by suicide every week. If ten people died on our roads every week due to traffic incidents, there would be a national outcry and it would be considered a crisis. The incidence of suicide is at crisis stage and increasing. It is believed that more people are dying by suicide than are accounted for, given the number of single-car accidents and the stigma associated with suicide, which sometimes prevents people from declaring that their loved ones have died by suicide.

  More people are affected by suicide despite the wonderful work of the National Office for Suicide Prevention and charities such as 3Ts, Pieta House, of which I was a proud director for six rewarding years, Console and many other organisations that are doing their own thing. They are saving lives every day. If a national suicide prevention authority were established, even with the objective of saving just one life per year, it would be worthwhile. Consider the wonderful achievement of the Road Safety Authority, RSA, in helping to reduce the number of road deaths dramatically every year since its foundation in 2006, although even one life lost on our roads is one too many. A suicide prevention authority should be created.

  When flicking through some of the national newspapers this morning, I noticed that a considerable amount of space had been given to the weather conditions. That is understandable. Reference was made to the number of Deputies who tabled Topical Issue matters and Priority Questions on this issue in the Dáil yesterday. That is also understandable, but what would our reaction be if ten people died every week because of the weather? There would be an even greater outcry.

  Recently, I read a report of the HSE. It stated:

If mental health becomes more of an everyday issue, that matters to us all, then the stigma attached to getting help can be reduced. While Irish society will continue to experience considerable change and face new challenges ahead, a mentally healthier Irish society will be much better able to cope.

This is true. We can only begin to reduce the stigma associated with mental health issues and suicide when we talk about them more. An organisation that I know has a mantra: "It's okay not to feel okay." This is what we tell our young people, but we do not provide the resources. We need to provide those resources to the national authority. We need to be able to share our stories, listen to one another and let one another know that we care.

  I am someone whose mental health was in crisis until recently.


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