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Irish Examiner
28-04-2025
- Health
- Irish Examiner
Irish Examiner view: Ireland at a crossroads over pharma
We should be grateful for some straight talking from one of Ireland's leading experts in the supply of drug remedies. After the disappointment over the ill-planned introduction of what really should have been a piece of good news — the welcome, if long overdue, provision of HRT — a warning is being sounded about the availability and affordability of other drugs. Michael Barry, the clinical director of the National Centre of Pharmacoeconomics and head of department at Trinity College, is the man to do just that. Speaking at the Irish Medical Organisation's annual meeting in Killarney, Prof Barry pointed to what could be the 'next big thing' in healthcare, weight-controlling and weight-reducing drugs. Ireland has one of the highest obesity rates in Europe and some estimates indicate that 1m people have a BMI of 30 or over. If the treatment was granted to everyone who might be eligible, the State's constantly increasing drugs budget, already standing at €4bn, would more than double to €10bn. Two drugs, Mounjaro and Wegovy, which are delivered through self-injectable pens, are under assessment for weight loss and other benefits including treatment of some forms of diabetes. Wegovy is made by the Danish manufacturer Novo Nordisk, who also produce another remedy, Ozempic. Mounjaro is a product of the American pharma giant, Eli Lilly, which has plants in Ireland. Patients and customers, as with the debate over HRT, will have their experience and expectations informed by what is happening with our next-door neighbours. Both drugs are available on prescription in the UK, although their cost means that usage is tightly controlled. Depending on dosage, a month's supply of Mounjaro can cost the NHS nearly €150, while Wegovy can range from €85 to €205. It's obvious, as Prof Barry states, that 'some difficult decisions' are required and that this thinking, with its potential impact on future budgets, has to be carried out quickly. The debate comes at a tricky time for relationships among government, suppliers, and practitioners. The manner in which politicians mismanaged the introduction of HRT, falling out simultaneously with pharmacists and voters, was the equivalent of missing an open goal in the advantageous management of public opinion. Woe betide the Department of Health if the new deadline of June 1 is not met. There is acrimony, too, about the delayed arrival of new cancer drugs into the Irish market. While some critics blame the launch timetables of pharmaceutical companies, others point to a lack of evidence that patient survival rates and quality of life are improved. With the HSE operating 'very close' to budget expansion limits, it is unsurprising that caution is being exercised. A final complicating factor has its foundations. Major companies have warned the European Commission that they may divert up to €100bn of planned investment to the US and they feel rising irritation from concerted attempts by Brussels to liberalise intellectual property rights. They are further chafing at EU requirements such as being forced to conduct multi-country clinical trials for drugs. The US is the largest market by sales for big pharma companies. EU medical and pharmaceutical product exports to the US totalled about €90bn in 2023, according to Eurostat. In all manners of ways, this is a relationship at a crossroads. Moment in time Staged or not, the photograph of US president Donald Trump and Ukrainian leader Volodymyr Zelenskyy facing each other knee to knee in the marble halls of a Vatican basilica, will be one of the enduring images of modern history, up there with those black and white stills from Munich in 1938. In an eerily prescient cartoon on that same morning, Irish Examiner cartoonist Harry Burton showed an isolated Zelenskyy clutching a prayer card while being handed a document entitled 'US Peace Plan'. A speech bubble simply said: 'Sorry for your loss.' Mr Trump, it must be noted for the future, has no great record of standing up to bullies or dictators, whatever belligerence he has displayed towards minor groups such as the Houthis. For the avoidance of doubt, it was he who signalled the frantic withdrawal from Afghanistan ahead of even Joe Biden, signing off on a 2020 deal with the Taliban to withdraw US forces. When it comes to security and alliances, he is the worst president of modern times, a blusterer whose blowhard approach will have been duly noted by China, North Korea, by his opponent in the Kremlin, and by Iran. Nato has to draw, and act upon, the necessary conclusions for the defence of Europe. The Russians will be keeping Crimea, says Mr Trump. Of course they will. The time to have stopped that would have been 2014. They are likely, also, to keep the land they have invaded. The question now is how to recognise, and ensure, what Mr Zelenskyy said he wanted this weekend: 'Full and unconditional ceasefire. Reliable and lasting peace that will prevent another war from breaking out.' Pope Francis once urged Ukraine to show the 'courage' of the 'white flag'. It's a phrase which may be heard more. Not over yet for Liverpool One of the great attractions of sport is that it always provides scope for a counter argument. Thus, yesterday's Premier League triumph by Liverpool, who have turned this season's competition into a procession, allows their many supporters to lay the ghost of an Alex Ferguson insult which has rankled for nearly three decades. My job, said the Manchester United manager, was to 'knock Liverpool off their fucking perch'. And in taking them to 20 top titles, overhauling the Merseysiders who were stuck on 18 since 1989/90, he did just that. After yesterday Liverpool have drawn level. They are equal, but not ahead. It's not over yet. Honours even does not cut it.
Irish Examiner
25-04-2025
- Health
- Irish Examiner
Prescribing 'King Kong' of weight-loss pills could see drugs budget jump to €10bn
The State's drugs budget could more than double to €10bn if a treatment known as the 'King Kong' of weight-loss drugs is approved for everyone eligible, a doctors' conference has heard. Some 'difficult decisions' are needed about the rising costs of all new drugs as soon as next year, clinical director of the National Centre of Pharmacoeconomics Professor Michael Barry warned. The drugs budget has been rising for the last decade, Prof Barry said. 'I think our drugs budget is at €4bn. I got it wrong in the past, I thought it would be €4bn by 2027, it won't, it's here today,' he said. He agreed with an estimate of one million people being eligible for these drugs, a figure raised by obesity expert Professor Donal O'Shea. This is based on them having a BMI of over 30. 'That would in effect add €6bn to the drugs budget, which would then take it to €10m,' he said. 'It's unaffordable, it's not going to happen, and I don't see it happening in my opinion,' Prof Barry said. The HSE is 'very close' to budget expansion limits, he told doctors at the Irish Medical Organisation's AGM in Killarney. Two drugs — Mounjaro and Wegovy — are under assessment for weight-loss and other benefits. However, he raised concerns about the potential impacts of increased spending. 'I anticipate that the assessment will be complete by the end of the year or the start of next year by the latest, then that is when the decision-making will need to be made,' he said. The question is 'do we fund them?' or 'do we fund them only for a sub-group of people who could benefit from them?' so it depends, they will be big decisions. Prof Barry also hit out at claims by pharma companies the HSE is to blame for delays bringing new cancer drugs to patients. 'Do [the companies] launch the product in Ireland first? Of course they don't. They go where the money is, the big markets — Germany, France, Italy, Spain,' he said. 'The HSE has nothing to do with this. The launching strategy of the pharmaceutical industry is up to themselves, that's why we've delays in access to medicines in this country.' He urged: 'All I'm asking for is an honest debate about this. It's always portrayed, in any article I read, there's a delay of up to two years and it's the HSE's fault. 'What I said today, clearly is it's not. I have no problem defending this — these are high-cost drugs and we should be asking about the value for money before we pay tax-payers' money. 'I think people need to be honest, and acknowledge a significant amount of the delay is down to the company themselves.' Read More Community drug projects welcome Government funding of €1.9m for addiction treatment services
