Projected impact of demographic change on the demand for pharmaceuticals in Ireland
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Presentation delivered by Dr Kathleen Bennett, Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James’s Hospital at the Irish Pharmaceutical Healthcare Association Meeting 2009.
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Projected impact of demographic change on the demand for pharmaceuticals in Ireland
- 1. Projected impact of demographic change on the demand for pharmaceuticals in Ireland Kathleen Bennett Department of Pharmacology & Therapeutics, Trinity College, National Centre for Pharmacoeconomics Dublin
- 7. Community Drugs Schemes Approximately 85% of total drug expenditure is through the Community Drugs Schemes. Three schemes cover 2.9 million (67%) of population. Ingredient cost was €1.1 billion in 2006 for first 3 schemes. % taken from HSE – PCRS 2006 annual report 14% 0.46% - High Tech Drug (HTD) 7.4% 3.9% 2.51% Long Term Illness (LTI) 18% 21.5% 36.03% Drugs Payment (DP) 60% 73.4% 28.85% General Medical Services (GMS) % expenditure % prescriptions (55 million items) % population Scheme
- 9. Number of GMS eligible patients by age (2006)
- 10. Average cost (ingredient) per year by age and gender (2006)
- 11. Average number of items per year by age and gender (2006)
- 12. Average ingredient cost/item and items/form 2000-2007
- 16. Total projected prescription items - GMS, DPS and LTI scheme 110 million items
- 17. Total projected ingredient costs – GMS, DPS and LTI schemes € 2.4 bn in 2021
- 18. Total prescription items by scheme – projected use model 76% GMS; 18.5% DP; 5.5% LTI scheme for distribution of items in 2021 67% GMS; 24.5% DP; 8.8% LTI scheme for distribution Ing costs in 2021
- 19. Sensitivity analysis for predicted prescription items
- 20. Sensitivity analysis for predicted ingredient cost
Notas del editor
- Here drug expenditure refers to all schemes (incl High tech, etc) and payment to wholesalers under HT to fit in with the graphs that follow.
- The year-on-year increase in drug expenditure under the Community Drug Schemes is amongst the highest in Europe.
- The number of eligible GMS patients has fallen by ~10% over the last decade, from 1.28 million in 1994 to 1.16 million in 2005. However, the 37.43 million items prescribed on the GMS scheme in 2005 represent an 96% increase over the 10 year period. 18.88 million items prescribed in 2005. Fall in GSM eligibility as the income threshold for means testing has increased in line with inflation but have lagged behind growth in average incomes.
- Out of the 140,000 people who currently hold non-means tested cards, about 15,000 are expected to be under this threshold and qualify for full medical cards; another 35,000 will get GP-only cards and 70,000 will get a new €400 a year Health Support Payment.
- 55 million prescript items in 2006 had risen to 60 million in 2007. We will focus on the first 3 schemes here. The equivalent Total exp in 2007 was 1.48billion
- IPHA agreement 2006
- Total number of items by 2021 estimated at 110 million items. 40 million GMS in 2006, 2mill LTI, 12 mill DPS=54 mill
- Total ingredient cost 2.4 billion in 2020 from 1.1 billion in 2006. Total expenditure figures similar trends 3.8billion by 2021. – likely to be an over-estimate now given recent changes to mark-up.
- Greatest increase expected in GMS scheme – but depends on assuming no changes in eligibility which may not be correct. By 2020, 76% of items within GMS scheme, 18.5% DP and 5.5% LTI
- 100k-121k for projected)
- . (2.2bn to 2.64bn for projected)
- PEA for high cost medicines and those with a significant budget impact Governs the supply terms, conditions and prices of medicines. First Agreement: 1993. The idea is that the post-patent price cuts will release resources to pay for new and innovative therapies in the future . There will be a 35% reduction in the price of post-patent medicines where a substitute is available. This will take place in two steps: the first of 20% and the second of 15%. It will also apply to hospital purchases and hospital-only products. Duration of 2006 Agreement: 4 years.
- Conservative estimates, likely to be greater increases.