There is “concern” about Irish politicians trying to interfere in the State’s process for funding expensive and rare drugs, according to the Minister for Health.Jennifer Carroll MacNeill said TDs and Senators as “lawmakers and legislators” should be aware of the need to keep the HSE’s national drug approval process stable and predictable. In an interview with The Irish Times, Carroll MacNeill said the health system is not being “uncaring or unthinking”, but buying expensive drugs with “very little effect” would compromise Ireland’s ability to buy future cancer drugs that work better. Last month, the HSE agreed to reimburse the cost of a drug for the treatment of Friedreich’s ataxia, the rare genetic disorder. The drug omaveloxolone, which is branded as Skyclarys, does not cure the genetic disorder but has been found to slow its progression in some patients. Last year, it was recommended that the HSE should not fund the drug, which was estimated to cost €280,000, per year, per patient. An estimated 200 people in Ireland are living with the condition. HSE senior management said last month it had negotiated a “substantially improved” price for the drug which it would now fund. The reversal came after a high-profile public and political campaign, which was supported by a number of Government TDs and Senators. Carroll MacNeill said the decision to fund the drug had followed official processes and “there wasn’t political interference in it”. Asked whether she was concerned about TDs and Senators putting pressure on the HSE to pay high prices for so-called orphan drugs for rare illnesses, she said: “It’s certainly a concern over time.” Carroll MacNeill said she could “completely understand” as a public representative why politicians would advocate for constituents who want access to certain drugs. “You want the best for your constituents, but it’s also true to say that we all benefit together by being in a society that’s predictable, that has stable, predictable processes that aren’t deviated by an individual politician’s whim or political pressure.”Carroll MacNeill also said pharmaceutical companies had increased “both” their direct lobbying of politicians and their lobbying efforts in general. [ HSE decision on Friederich’s ataxia welcome, but highlights ever-present conundrumOpens in new window ]“It’s certainly true that I’ve seen over the last 12 to 18 months a change in some of the engagement by different pharmaceutical companies.” She suggested that she would now hear adverts on the radio for different drugs, “and then I might hear it in the Dáil”.She said if drugs are found to be more limited in their efficacy, that “changes” how much a public health system should pay for them. “And the reason for that is not to try to be uncaring or unthinking... it’s to try to get the best outcome for the most amount of people in the State. So if we’re making a choice to fund a very expensive drug with very little effect, that compromises our ability to buy the next oncology drug that does work.” Carroll MacNeill said Ireland’s budget for pharmaceuticals, which is set on an annual basis, is projected to reach €4 billion, “and we can’t keep pace with it”. “That’s more than twice the defence budget, it’s nearly the budget of the Department of Justice, which is €6 billion.” The Minister for Health is also planning to use a major meeting with European colleagues in Dublin this month, as part of Ireland’s presidency of the Council of the European Union, to find ways for countries to take a “stronger collective approach” against big pharmaceutical companies that are able to charge high prices for new rare-disease drugs.