‘This is the reality of an ageing population’-Pharmacy expert on NI’s £875m medicine bill

A pharmacy expert has spoken about the soaring costs of medicine in Northern Ireland, reaching an all-time high of £875m spent last year.

The Department of Health attributed the cost, which was less than £600m a decade ago, to factors like an ageing population and “highly effective” but expensive new medications.

Further detail was provided in a recent public consultation, showing the high cost of social deprivation and the knock-on effects for patients relying on prescriptions as they languish on the worst waiting lists in the UK.

The consultation added that despite considerable efforts to bring down costs, including £200m of savings over the last eight years, that without change the health service “will struggle to continue funding expensive new medicines and technologies and keep up with the demand of an increasing and ageing population.”

With nearly 46 million individual items dispensed in 2024, official figures showed that £102m was spent on medication for the central nervous system and over £50m each for respiratory and cardiovascular medicines.

Professor Sharon Haughey is from the Queen’s University School of Pharmacy.

“This is the reality of an ageing population, where we want people living as long and as well as possible,” she told the Irish News.

While many new medications come at a premium, she explained that once they came off patent the NHS had the option of authorising “biosimilars,” essentially cheaper non-branded versions which can save millions.

“Another thing we have to remember is that for many patients these medicines are life-changing, it could mean they may not need things like hip replacements as quickly.

“There’s also phenomenal cancer treatments that make such a difference to peoples’ lives, but the reality is that they’re expensive.

“The other point is that medicines are not cheap to produce. We’ve often had problems accessing medicines because the industry can’t access raw ingredients.

“All of that drives up your prices.”

She said a major effort in recent years has been to avoid patients staying on prescriptions they no longer need.

“When someone passes on, we can see people bringing in a phenomenal amount of medication that they haven’t used,” she said.

“So we all have our own individual responsibility to use the health service appropriately.

“What we have tried to do in recent years is optimise medicines. So if an older patient is on 20-plus medicines, we will do a full review and try and reduce that.”

Another positive trend is medicines becoming more personalised, with the genetic profile of patients allowing more informed decisions about the right medication.

Starting her pharmacy career in the Republic, Prof Haughey said she was “shocked” at the prescription charges many faced for items like asthma and dermatology medicines.

“It made me think about how lucky we were to have access to medicines for free in the north,” she said.

“It probably will need to be relooked at in the future, but we would need to consider how community pharmacies would deal with that on the paperwork end.”

On the much higher rates of prescriptions in deprived areas, she said it was not for the health service alone to reverse the trend.

“If you’re living in a deprived area and not putting on the heat as much over winter, your asthma won’t be as well controlled,” she said.

On Monday, the Taoiseach Micheal Martin spoke of his hope the Irish pharmaceutical industry can still escape the threat of increased tariffs from US President Donald Trump.

Prof Haughey added: “I know Donald Trump has strong notions about Ireland’s pharmaceutical industry.

“It’s just an unknown right now, I would say these companies won’t be making huge investments like setting up new factories over the next few years.

“But if he’s causing major ripples in the global economy, then yes it could affect the price of medicines as well.

“It creates uncertainty which will maybe stop immediate investment, it’s not helpful – put it that way.”