Irish prices for the 10 generic drugs most commonly prescribed to people aged 50 and over are on average 2.7 times more expensive than those in the UK, and the prices of two such drugs are six times higher, says new research.
The study, which looked at multiple medication use in people aged over 50 in Ireland, found that the annual medicines bill for this age group is 600 million euros. One in five of this group is regularly taking five or more medicines (polypharmacy), accounting for 54% of this total. However, only one in five medicines prescribed to people in this group who are on polypharmacy is generic, which compares poorly with other nations such as the UK and US, say the researchers, from The Irish Longitudinal Study on Aging (TILDA) at Trinity College Dublin.
They point out that current international guidelines recommend regular medication review and substitution with a cheaper medication with the same therapeutic outcome where possible, and also note that Irish prices for the generic drugs that were used were "substantially higher" than in the UK. In the case of two - omeprazole and lansoprazole – the prices were six times higher in Ireland.
Because in 2010 only one in five medicines used by people aged 50 and over who reported polypharmacy was a generic, the state could have saved nearly 30 million euros that year by increasing the use of generics, the authors estimate.
Also, up to 152.4 million euros could have been saved that year if a system of reference pricing, based on groups of similar drugs, had been used, they add.For some of the most commonly-used drugs, the researchers estimate that the potential annual savings from increasing the use of generics and reference pricing are, respectively:
- proton pump inhibitors: 10 million euros and 17.8 million euros per year;
- angiotensin-coverting enzyme (ACE) inhibitors: 2.9 million euros and 4 million euros each year;
- statins: 900,000 euros and 39.9 million euros a year; and
- bronchodilator combinations: up to 8.4 million euros per year.
The report’s authors make a number of other recommendations, including: - regular medication review for those taking five or more medications; - substitution for a cheaper medicine with the same therapeutic outcome where possible; and - widespread implementation of an easily-accessible system for all prescribers to enable comparison of prices for all patients.
Commenting on the results, TILDA's principal investigator, Professor Rose Anne Kenny, said: "this report highlights the extent of the medication burden in adults in Ireland and where considerable cost savings could be made. Polypharmacy is common and potentially puts the ageing population at risk of serious complications."
"Given that polypharmacy accounts for over half of the annual costs of prescribed medications in the entire population aged over 50 years, review of medications and generic substitution should offer opportunities for considerable savings," she added.- Meantime, Ireland's Department of Health has this week reported that the number of prescription items dispensed under the General Medical Services (GMS) increased by almost 7% between 2010 and 2011, but that the average cost per prescribed item fell 8%, and has decreased for two years running.
37% of the population is now covered by a medical card, an increase of almost 45% over the last decade and a rise of nearly 5% between 2010 and 2011. In contrast, the number of people covered by private health insurance has been declining since 2008, says the data, which appears in the fifth edition of the Department's annual Health in Ireland: Key Trends report.