Pharmaceutical pricing and reimbursement : an Irish perspective

Abstract

There has been a five-fold increase in state expenditure on medicines under the Community Drug Schemes in Ireland over the last decade (1994 to 2004). As a result of this marked increase in pharmaceutical expenditure, the issue of obtaining value for money from the drugs budget arises. The research presented in this thesis was undertaken in response to the issues of concern to the Department of Health and Children (DoHC) in relation to pricing and reimbursement of pharmaceuticals in Ireland. The aim of this thesis is to determine the potential impact of implementing various pharmaceutical cost- containment measures in the Irish healthcare system. Similar increases in state expenditure on medicines have occurred across other European Union (EU) Member States, and various policies have been adopted by decision makers to contain this rise in pharmaceutical expenditure, including price controls, restriction of publicly reimbursed drugs by positive or negative lists, promotion of generic markets, prescribing budgets and patient co-payments. It is difficult to establish which of the different cost-containment strategies is most effective as they are rarely applied in isolation and it is often difficult to determine the influence of each in an overall effect. Therefore, before any cost-containment strategy can be introduced, a full assessment of the potential impact is necessary.