Ireland has launched the country's first "preferred drugs" list, which identifies lansoprazole as the preferred proton pump inhibitor (PPI) and simvastatin as the preferred statin. 

Products for the country's first-ever preferred drug initiative have been selected by Health Service Executive (HSE)'s recently-established Medicines Management Programme.  The HSE says it is asking doctors to prescription lansoprazole (Takeda's Zoton FasTab) and simvastatin (Merck & Co's Zocor) in order to save money, both for patients who pay for their medications and to deliver savings of an estimated 15 million euros for the taxpayer. 

PPIs and statins account for up to 15% of the HSE's drug budget, which is forecast to rise to 2 billion euros this year if no action is taken to curb spending. "By changing existing patients to the preferred drug, and by prescribing these drugs for new patients, significant savings can be achieved," says the Executive.

It estimates that if 50% of all PPI prescriptions were written for lansoprazole instead of the other PPIs on the market, the HSE would save in the region of 7.5 million euros on the drugs budget in 2013, while by switching just 25% of all prescribed statins to simvastatin, it could make savings of around 8 million euros.

Patients who do not have a medical card and purchase their drugs privately could save more than 300 euros a year if they switched to the preferred drugs, says the HSE, and it advises patients to discuss their suitability for changing to the preferred drug with their doctor.

At present, there are five PPIs on the market in Ireland. Following a review of these products, the MMP has reported that they differ significantly in price but little in terms of efficacy. Switching to lansoprazole from a more expensive PPI would result in a saving of more than 300 euros per annum per individual, it says.

There are also current five statins on the Irish market, and these products again can vary significantly in terms of price. Patients who do not have a medical card and who pay for their medicines, and who are suitable for treatment using the preferred drug, could make savings in the region of 130 euros per annum by switching to simvastatin, it adds.

"Using the preferred drugs identified by the Medicines Management Programme makes sense for the patient, prescriber and the taxpayer," commented Professor Michael Barry, clinical lead for the Programme, which is aiming to secure savings totalling 20 million euros this year. The HSE emphasises that savings achieved in this way do not impact on the provision of front-line healthcare services.

According to Prof Barry, the vast majority of patients should have no problem switching to the preferred drugs, and he added that 80% of people currently taking PPIs are on doses which are too high.

The Executive also points out that last year its drugs budget exceeded 1.7 billion euros under the Community Drugs Schemes (CDS), and that this represents a greater than five-fold increase over the past decade. "Against this background, it is essential to ensure that the prescribing of medicines is safe, effective and cost-effective," it says.