Malcolm Noonan (Carlow-Kilkenny, Green Party) | Oireachtas source

I thank the Senator for raising this important commencement matter. As she stated, I am taking this question on behalf of my colleague, Minister for Health. The Government is committed to the ongoing implementation of the national cancer strategy and the delivery of quality care for cancer patients. The Government also acknowledges the importance of access to medicines and has made considerable investments in new medicines in recent years.

Last year, a record of more than €3 billion in public funding was spent on medicines for patients in Ireland. This represents almost €1 of every €8 spent by the State on healthcare. This is in the context of overall total allocation of the health service for 2024 of €22.5 billion. Budgets 2021, 2022 and 2023 included dedicated funding for new medicines of €98 million. This has enabled the HSE to approve reimbursement for 148 medicines or licence extensions, including 61 for treating cancer and 39 for treating rare diseases. In addition, the Minister secured funding in budget 2024 for an additional 34 staff across the pricing and reimbursement process. These measures will enable the assessment of a greater number of medicines at a quicker pace and ensure that patients can easily remain informed on progress.

I am pleased to confirm that hiring of these additional staff has now commenced, however, expenditure has grown rapidly, and we must ensure that sustainability of medicines expenditure. We must strive to maximise the available investment and provide as many people as possible with access to medicines that they need. In this context, there are policy and operational options being pursued and will be intensified including, for example, maximising the use of generic and bio-similiar medicines across community and hospital settings. The Senator also made positive suggestions in her opening commentary. Budget 2024 made €30 million available for new drugs.Of this sum, €20 million has been invested directly by the Government and €10 million has come from efficiencies to be identified by the HSE. This funding has enabled the HSE to approve reimbursement for 13 new medicines so far in 2024.

As regards private health insurance, this is a voluntary, community-rated market, which is underpinned by certain principles, including minimum benefit, that are set out in law. The Health Insurance Act 1994 (Minimum Benefit) Regulations 1996 require insurers to offer a minimum level of cover to every insured person. The Minister does not have a role in the commercial decision-making of any private health insurer.

Private health insurance companies operate as commercial entities in a competitive private health insurance market. Beyond prescribing under the regulations the minimum level of coverage that health insurers must provide, the State is not in a position to direct any insurer to provide cover for any particular procedure, service or medicine, or direct how that cover is to be provided. Insurers are free to provide treatments beyond what is provided for in these regulations or what is approved for use in public hospitals.

I stress that Ireland is absolutely open for business and welcomes pricing and reimbursement applications from all marketing authorisation holders for all newly approved medicines. I note the points the Senator made about Ireland’s market being small. The Minister is committed to working to improve the reimbursement system. The Senator’s point about learning from other jurisdictions is important too.