Deputy Maureen O’Sullivan: Coming from a medical background, the Taoiseach will agree that we need sustainable models of medicine development and medicine procurement. We are seeing significant advances in drug treatment for life-threatening illnesses and also in respect of non-communicable illnesses, but there has also been a massive escalation in prices by the pharmaceutical companies. Some of the prices being charged are extortionate. There are many examples in this regard but I will just provide one that relates to overpricing. The University of Pennsylvania was able to produce a new treatment for cancer, CAR-T, for $15,000. Novartis is producing it at a cost of $475,000. We know here what has been happening with Orkambi, Spinraza and Prempro. Drugs for Neglected Diseases Initiative, DNDI, based in Geneva but with offices around the world, was able to come up with a plan using certain drugs for $150 million but big pharma has stated that it would cost €2.5 billion to do the same. It is also the case that Ireland is falling behind other European countries when it comes to access to medicines for illnesses such as MS.
Opposition is growing to this monopoly exercised by the pharma companies. Only last weekend, there was a lawsuit of over 40 US states against pharmaceutical companies for overpricing in respect of cancer and diabetes drugs. If one looks at the base level of development of these drugs, the research is being carried out by publicly-funded universities and research institutes. Phenomenal work is being done. The patents for newly developed drugs are then sold to the pharmaceutical companies and it is at that point that reform is needed in order that universities and research institutions are supported in challenging the pharmaceutical companies so that conditions are attached regarding the future affordability of medicine. If the latter happens, we will not be obliged to overpay for medicines that were originally development with public funds. University College London has done a serious amount of work on this issue. In 2016, the EU Council passed strong recommendations in respect of this kind of reform but these need to be implemented now with a co-ordination mechanism. I am asking that Ireland be involved in this regard. I am also asking that, as called for at a recent access to medicines conference, Ireland support the Italian resolution on transparency on this matter at the World Health Assembly in Geneva next week.
However bad the prohibitive cost of medicines here, we can only imagine what it is like in the global south, not only for the difficult illnesses but also for non-communicable ones. I refer here to certain basic illnesses from which people are dying. Sustainable development goal 3 is about access to affordable medicines. We also signed a UN agreement last year with an explicit commitment to promote increased access to affordable, safe, effective and quality medicines.
I ask that the Taoiseach consider three aspects: capacity-building and strengthening of the universities and research institutes when they are negotiating with the pharmaceutical companies which are driven by shareholder profit; retaining some drugs in public ownership, fully developed and distributed through the public health system, which model exists in both Cuba and Brazil, and in parts of the United States; and that the Government adopt a procurement policy which actively, and in a timely fashion, will take up the less expensive biosimilar alternatives when the patents relating to the original drugs expire. Otherwise we will keep on paying over the price for medicines that are badly needed.
The Taoiseach: I thank Deputy Maureen O’Sullivan for raising this important issue. I very much agree with her that the cost of new medicines is extremely high. That is the case across the world. Notwithstanding that, so far this year – it is only May – the HSE has approved 23 new medicines for use in this country and is considering a number of other applications. One of the most effective things we can do is co-operate with other countries when it comes to the procurement of new medicines. In the past year or so, we formed an alliance with Belgium, the Netherlands, Luxembourg and Austria – the BeNeLuxA initiative. In fact, there is a meeting taking place in Dublin today involving health officials from all five countries. The purpose of the initiative is so that all five countries can co-operate in the context of scanning the horizon for new developments and new medicines, sharing information on effectiveness and cost and, potentially, tendering or procuring as a group in the future in order that we get a better price for our taxpayers and citizens.
There should be a single process at EU level for recommending whether new medicines are reimbursed. We already have the European Medicines Agency, which can license medicines for use across the European Union but does not have a role in determining whether they should be reimbursed or at what cost. Sometimes some of the drug companies play countries off against each other. It is up to countries to stop them from doing this and that is where, at a European level, we should have a new initiative moving beyond an EU-wide licensing regime to an EU-wide regime for determining which medicines should be reimbursed and what is a fair price for health systems to pay.
I have not seen the Italian resolution the Deputy mentioned. I will ask the Minister for Health to contact her directly in the context of indicating whether we are in a position to support it. I absolutely agree that we need to make better use of biosimilars and that when drugs come off patent, we should be using the generics rather than the branded items. Those savings that can be created should be retained in the budget to fund new medicines.
Deputy Maureen O’Sullivan: The reality is that the cost of medicines is extortionate and that there is demand for them. We had the awful reality of the insured and the uninsured with the same life-threatening illnesses being treated differently. It is terrible for officials and doctors to have to weigh up the cost of medicine vis-à-vis the cost of a life and whose life means more and, therefore, gets the more expensive medicine. It cannot be a competition between, for example, a drug that will prolong a life for ten months and another that will prolong it for 24 months, as to which one we should choose. There should be equal access for everybody. A different approach to the pharmaceutical companies is needed at EU level, at UN level and nationally. I would be in favour of a working group here because there are practical suggestions being made that are achievable. Pharmaceutical companies provide jobs and corporate taxes. They are giving with one hand but what is the point in that if they are taking back with the other by charging Ireland and other countries so much more for medicines that should be much more reasonably priced. There is a more progressive model of research and development that is committed to access and affordability and that is what we need to pursue.
The Taoiseach: I broadly agree with the Deputy. In my conversations with the Minister for Health, I will advise him that the Deputy has raised these issues. He will follow up directly with her.
