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Medicines mismanagement

Despite the promise to fund nine new innovative medicines, across the areas of oncology, cardiology, rheumatology and dermatology that were approved some months ago, patients are still waiting.

This is despite the Department of Health and HSE playing a slow game of ‘pass the parcel’ in relation to who would make the decision to fund these undeniably expensive medicines. However, after rigorous assessment processes and the Department firmly stating that the ultimate decision and the necessary budget lay with the HSE, patients and clinicians are still in limbo. The HSE is also under fire for refusing to fund a breakthrough treatment for Duchenne muscular dystrophy that is available to patients in Northern Ireland and a treatment for a rare form of emphysema, which has been available on a compassionate basis to Irish patients for many years but is due to be stopped.

From being a country where patients had good access to new medicines, Ireland is falling down the list compared to our counterparts in Europe, according to the Irish Pharmaceutical Healthcare Association (IPHA). The situation for cancer medicines is particularly negative. In 2016, only 20 per cent of new cancer medicines launched internationally in 2014-15 were available to patients in Ireland. Ten years ago, it was a very different case.

While the cost of new innovative medicines is a significant challenge for our health budget, when decisions are made to fund treatments, surely it is not too much to ask that they are then promptly made available to patients, instead of dragging-out the inevitable to try and balance this year’s books?

 And in another worrying development, as Niamh Cahill investigates in this issue, there have been reports of hospital inpatients being asked to source high-tech medications, such as monoclonal antibodies, prescribed by hospital clinicians, from their community pharmacies while they remain in hospital — in an apparent attempt to move the cost from the hospital budget to the community drugs budget.

GPs and pharmacists are concerned about the emerging practice, which has health and safety repercussions as well as being stressful and confusing for patients.

The HSE must investigate these reports and put a stop to such behaviour.

While it is imperative that we obtain the best possible value for money when negotiating on all medicines, and that we fund treatments that have a proven benefit, it is clear that the current system and behaviour of the purse masters is not acceptable. It is completely unfair to affected patients and to frustrated clinicians who have been able to see first-hand the positive results from local clinical trials and then have to deny needy patients the best option for treatment, as approved medications are caught in an endless limbo.

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