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 Header Item Medicinal Products Availability (Continued)
 Header Item Anti-Evictions Bill 2018: Second Stage [Private Members]

Wednesday, 12 December 2018

Dáil Éireann Debate
Vol. 976 No. 5

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(Speaker Continuing)

[Deputy Jim Daly: Information on Jim Daly Zoom on Jim Daly] I want to assure Deputy Deering that the Minister for Health works tirelessly to address issues around access for patients to new and innovative medicines. The Oireachtas has put in place a robust legal framework in the Health (Pricing and Supply of Medical Goods) Act 2013, which gives statutory powers to the HSE to assess and make decisions on the reimbursement of medicines, taking account of a range of objective factors and expert opinion, as appropriate. The Act specifies the criteria to be applied in the making of reimbursement decisions, to include the clinical and cost effectiveness of the product, the opportunity cost and the impact on resources that are available to the HSE.

While the 2013 Health Act does not include provision for a specific rule set when assessing orphan drugs, the HSE and the NCPE seek to take into account issues such as patient numbers and the nature of the condition to be treated when evaluating these medicines. The criteria that apply to the evaluation process allow sufficient scope for the HSE to take on board the particular circumstances that pertain to orphan drugs. In reaching its decision, the HSE will examine all the relevant evidence and will take into account such expert opinions and recommendations that are appropriate, including from the NCPE.

The Deputy rightly identifies that increasingly drugs are being developed to target rare conditions and that these drugs often come with very high list prices. In that respect, the HSE is required under the Act to have regard to the funding challenges that these drugs represent. It does this by drawing on the criteria contained in the Health Act, including the potential or actual budget impact of the drug in question and the cost effectiveness of meeting health needs by supplying a particular item rather than providing other health services. These are difficult decisions but recognise the core challenges of the availability of finite resources in the face of ever competing demands. Since the signing of the four year framework agreement on the supply and pricing of medicines in 2016, a significant number of orphan drugs have been reimbursed by the State.

Notwithstanding the challenges which orphan drugs present and the fact that the HSE and NCPE are mindful of these issues when assessing orphan medicinal products, a number of changes have been introduced to address those challenges. In June 2018, a technology review committee for rare diseases was established. This committee is now operational and has already completed work in relation to orphan products. As well as examining the methodologies for assessing orphan drugs, it will also consider the views of patients, caregivers and examine the wider issues surrounding health technology assessments. In addition, the composition of the HSE drugs group is being expanded to include two representatives from the National Patients Forum and more clinical expertise in the area of rare disease. Both of these measures are intended to provide greater balance and transparency to the assessment process as a whole.

The challenge of accessing innovative medicines at affordable prices is one shared by most, if not all, developed countries. It is estimated that in the region of 45 new molecules are due to receive market authorisation in Europe each year over the next five years. It is in this high-tech space, including orphan drugs, that the greatest challenges will arise in the years ahead. A significant development in Ireland’s international agenda was joining the BeNeLuxA initiative on pharmaceutical policy in June 2018. This collaboration will support the Government's objective of co-operating with other European countries to identify workable solutions in an increasingly challenging environment to secure timely access for patients to new medicines, including orphan medicines, in an affordable and sustainable way.

Deputy Pat Deering: Information on Patrick Deering Zoom on Patrick Deering I thank the Minister of State for his comprehensive reply. I welcome the initiatives commenced this year, in particular the review committee established in June but it is important a timeline is put in place for completion and publication of that review.

It is also important that these drugs are affordable and that the State is not in hock to, or taken advantage of by, the large pharmaceutical companies. Crucially, the people who need these drugs need them now because they may not be around in two years' time when they become available.

As I said, it is important the initiative announced earlier in the year is progressed more quickly such that if a new disease is identified and an adult or child needs drugs that will be of huge benefit to them, they can access them. I ask the Minister of State to ensure that a timeframe is set for completion of that initiative such that the process can be more efficient going forward.

Deputy Jim Daly: Information on Jim Daly Zoom on Jim Daly I will take on the Deputy's challenge of putting in place a timeline for the range of initiatives outlined in my speech. There always will be tension between the State as the purchaser of important drugs and the giant pharmaceutical companies producing and supplying them, often for lottery type amounts of money. The State has to ensure affordability not only in terms of fiscal governance but to ensure they are available to everybody who needs them. If we pay over the odds for any particular drug we would limit the number of people who can avail of them. Notwithstanding those challenges, the Deputy has asked that we be more prescient in our timelines and I will pass on his request to the Minister.

Anti-Evictions Bill 2018: Second Stage [Private Members]

Deputy Mick Barry: Information on Mick Barry Zoom on Mick Barry I move: "That the Bill be now read a Second Time."

Last week, Threshold published its annual report 2017. The report revealed that 32% of the 75,000 calls it received last year were in regard to eviction notices. The previous year, 2016, eviction notices accounted for 14% of calls to Threshold. Calls regarding eviction notices have more than doubled in one year. According to Threshold in Ireland, and in Europe generally, the private rental sector is the leading source of homelessness through evictions, legal and illegal. According to Focus Ireland, 69% of homeless people report that their last stable home was in the private rental sector. It is sheer insanity in the midst of the greatest housing crisis in the history of this State to allow the flow of evictions from the private rental sector to continue without a serious attempt to stem the flow. This Bill represents a serious attempt to stem the flow.

The 2017 report also reveals that the most common type of eviction notice references sale of property as the grounds for eviction and that there has been an increase in the number of eviction notices reported to Threshold in 2017 which reference renovation of property as the grounds for eviction. Half of all eviction notices dealt with by Threshold in 2017 were evictions on the grounds of renovation or sale of property. If this Bill were passed it would prevent all of these evictions. During Leaders' Question today the Taoiseach said the Bill we are discussing tonight is too extreme.


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