A Retrospective Analysis of Reimbursement Timelines in Ireland: What Does a 10-Year Analysis Show?
Author(s)
Emma McGrath, MSc, BSc1, Emer Gribbon, MSc, BSc1, Emma Bryan, PhD2, Brenda Dooley, MSc1.
1AXIS - The Reimbursement Experts, Dublin 2, Ireland, 2AXIS - The Reimbursement Experts, London, United Kingdom.
1AXIS - The Reimbursement Experts, Dublin 2, Ireland, 2AXIS - The Reimbursement Experts, London, United Kingdom.
OBJECTIVES: In Ireland, the National Centre for Pharmacoeconomics (NCPE) conducts assessments for the Health Service Executive (HSE), issuing reimbursement recommendations following rapid review (RR) and/or a full health technology assessment (HTA). After price negotiations with the HSE, a final recommendation is made. This research evaluates patterns in time to reimbursement (TTR) over the last decade and explores effects of condition-specific Managed Access Protocols (MAPs).
METHODS: Reimbursement data was collated in Excel® using publicly available sources from NCPE, Primary Care Reimbursement Service, and HSE: • NCPE assessment dates & recommendation • HSE Drugs Group recommendation • Reimbursement date Two condition-specific MAPs were identified for atopic dermatitis (AD) (n=4) and migraines (n=6).
RESULTS: N=347 assessments reimbursed between June 2016 and June 2025 were identified. Average TTR (aTTR) was 602.51 days; 53.31% (n=185) were reimbursed after RR (aTTR 336.20 days), 46.69% (n=162) after HTA (aTTR 906.63 days) .RR assessment time improved over the decade and stabilised post 2020 (2021: 33.21 days; 2025: 31.21 days). Time from HTA submission to outcome has increased steadily over the last decade (2016: 191.26 days, 2025: 374.88 days).aTTR for AD medicines was 1235.00 days for the first intervention, and 227.67 days for subsequent interventions (all RR only). For migraine medicines, aTTR was 725.00 days (first: 1140.00 days; subsequent: 642.00 days). Across both MAPs, RR time for first interventions (11.00 days, 27.00 days) were shorter than subsequent interventions (30.33 days, 47.08 days).
CONCLUSIONS: aTTR in Ireland remains challenging, with dynamic patterns over the last decade regarding TTR and consistent increases in HTA assessment time, despite consistencies in RR assessment. Analysis shows that first medicines added to MAPs have longer aTTR. However, only subsequent medicines added to the AD MAP have below aTTR, the medicines on the migraine MAP were longer than aTTR. This suggests HTA needs may vary by indication when entering MAPs.
METHODS: Reimbursement data was collated in Excel® using publicly available sources from NCPE, Primary Care Reimbursement Service, and HSE: • NCPE assessment dates & recommendation • HSE Drugs Group recommendation • Reimbursement date Two condition-specific MAPs were identified for atopic dermatitis (AD) (n=4) and migraines (n=6).
RESULTS: N=347 assessments reimbursed between June 2016 and June 2025 were identified. Average TTR (aTTR) was 602.51 days; 53.31% (n=185) were reimbursed after RR (aTTR 336.20 days), 46.69% (n=162) after HTA (aTTR 906.63 days) .RR assessment time improved over the decade and stabilised post 2020 (2021: 33.21 days; 2025: 31.21 days). Time from HTA submission to outcome has increased steadily over the last decade (2016: 191.26 days, 2025: 374.88 days).aTTR for AD medicines was 1235.00 days for the first intervention, and 227.67 days for subsequent interventions (all RR only). For migraine medicines, aTTR was 725.00 days (first: 1140.00 days; subsequent: 642.00 days). Across both MAPs, RR time for first interventions (11.00 days, 27.00 days) were shorter than subsequent interventions (30.33 days, 47.08 days).
CONCLUSIONS: aTTR in Ireland remains challenging, with dynamic patterns over the last decade regarding TTR and consistent increases in HTA assessment time, despite consistencies in RR assessment. Analysis shows that first medicines added to MAPs have longer aTTR. However, only subsequent medicines added to the AD MAP have below aTTR, the medicines on the migraine MAP were longer than aTTR. This suggests HTA needs may vary by indication when entering MAPs.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR8
Topic
Health Policy & Regulatory, Methodological & Statistical Research
Topic Subcategory
Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas