Ever wonder could Ireland do better in improving access to medicines? 

 

Its essential for patients to have access to important medicines, especially when ill. Ensuring medicines are safe and available is fundamental to everyone involved in the pharmaceutical supply chain. This especially means manufacturers, all the way to the doctors and nurses who administer these medicines and the health authorities and medicine (pharmaceutical) regulators who make the rules and create the environment in which such medicines are used and made available. 

Sadly, important older medicines are often in short supply in Irish Hospitals. This is increasingly common. There are numerous reasons, but some important ones are actually self-evident and can be addressed with some imagination and flexibility.

Its obvious as older medicines decline in use, the volumes fall and the unit costs of production rise. Manufacturing small batch sizes incurs much higher unit costs. For this reason, some pharmaceutical manufacturers no longer maintain Irish license approvals for certain older medicines. In order for Doctor's and Pharmacists to secure such products when required for patients, they must be sourced as "unlicensed medicines" or ULM's or "specials". Distributors import these medicines from 3rd countries at greatly increased costs to the end customer - usually our local hospitals.

Allied to production costs, the cost of maintaining license approvals from the regulators for many low volume medicines has become prohibitive. This is especially so where Ireland insists on unique Irish packaging for medicines, although the identical medicine is already available in the UK usually from the same manufacturer. This is driven by historical differences in the original license approved in Ireland and the one approved in the UK. Many of these differences originated years ago.

Although understandable at the time, there is no reason not to harmonise the license for well established medicines across the UK and Ireland from the same manufacturer. With safety profiles well understood and clinical use identical in practice, why do we insist on manufacturers packaging and labelling the same product in the UK differently for Ireland?  

The solution is to agree to common packaging with a combined patient information leaflet for the UK and Ireland for such medicines. This would mean Irish medicines could be manufactured in the larger production runs used for the UK. This would reduce the unit costs thereby reducing the selling price in Ireland. It would also reduce the selective ceasing of production and licensing of older medicines for Ireland by manufacturers.

Aribamed discuss daily with customers ways in which to achieve better value and more choice in medicines used by Irish patients. We believe the costs imposed on manufacturers and distributors are contributing to practices which is needlessly driving up the costs of supplying important older medicines. 

This debate is not trivial. Important medicines will get used even if the health system must pay a much higher price through decisions it has made or failed to make. Its critical for our health system to ensure a sustainable supply of important older medicines at a fair value. 

Aribamed is considering publishing a series of articles challenging the present customs and practices, which escalate the costs of providing and maintaining affordable access for established medicines to Irish patients. Anyone interested in contributing - please just email enquiry@aribamed.com.