An Irish Retrospective Analysis of Oncology Reimbursement Applications Considered by HSE Drugs Group 2022-2024
Author(s)
Kevin T. Morris, MPH1, Hafizh A. Boenjamin, MD2, Glenn Kelly, MSc2.
1AstraZeneca, Dublin, Ireland, 2Market Access, AstraZeneca, Dublin, Ireland.
1AstraZeneca, Dublin, Ireland, 2Market Access, AstraZeneca, Dublin, Ireland.
OBJECTIVES: To describe oncology indications considered by HSE Drugs Group in 2022-2024 capturing reimbursement status and reporting on frequency of Drugs Group consideration per new indication/medicine.
METHODS: In Ireland the HSE Drugs Group advise the HSE leadership team on reimbursement applications. They meet monthly and may ask a pharmaceutical company to improve a commercial offer or provide additional evidence to support a positive reimbursement recommendation. They subsequently may consider a new indication/medicine more than once. The Drugs Group minutes were analysed across 2022-2024 for oncology applications and cross-referenced with reimbursement status and reimbursement application type (full HTA or Rapid Review only).
RESULTS: 52 oncology indications/medicines were discussed at HSE Drugs Group across the 3-year period and of those 41 were reimbursed (79%). There was no meaningful difference in reimbursement rate in oncology indications/medicines recommended for a full HTA (41) versus those which were not (11), 78% and 81% respectively. Of the nine- oncology full HTA applications not reimbursed, reasons for non-reimbursement included a paucity of clinical data, specifically, two applications were based on data from Phase 1 and Phase 2 trials, and two lacked robust comparative evidence against the standard of care. Among the remaining five, value was a concern, four had no or only modest improvement in overall survival, while one was a combination regimen which was above the cost-effectiveness threshold. Of the 41 reimbursed oncology applications 36 were considered by HSE Drugs Group once (88%). Of 11 applications not reimbursed 8 were considered by Drugs Group once only (73%) over the 3-year period.
CONCLUSIONS: In the period 2022-2024 almost 4 in 5 oncology applications discussed by HSE Drugs Group in Ireland were reimbursed. Data packages and commercial offers appear to be largely acceptable in that a decision can be made in the majority of cases with one consideration by Drugs Group.
METHODS: In Ireland the HSE Drugs Group advise the HSE leadership team on reimbursement applications. They meet monthly and may ask a pharmaceutical company to improve a commercial offer or provide additional evidence to support a positive reimbursement recommendation. They subsequently may consider a new indication/medicine more than once. The Drugs Group minutes were analysed across 2022-2024 for oncology applications and cross-referenced with reimbursement status and reimbursement application type (full HTA or Rapid Review only).
RESULTS: 52 oncology indications/medicines were discussed at HSE Drugs Group across the 3-year period and of those 41 were reimbursed (79%). There was no meaningful difference in reimbursement rate in oncology indications/medicines recommended for a full HTA (41) versus those which were not (11), 78% and 81% respectively. Of the nine- oncology full HTA applications not reimbursed, reasons for non-reimbursement included a paucity of clinical data, specifically, two applications were based on data from Phase 1 and Phase 2 trials, and two lacked robust comparative evidence against the standard of care. Among the remaining five, value was a concern, four had no or only modest improvement in overall survival, while one was a combination regimen which was above the cost-effectiveness threshold. Of the 41 reimbursed oncology applications 36 were considered by HSE Drugs Group once (88%). Of 11 applications not reimbursed 8 were considered by Drugs Group once only (73%) over the 3-year period.
CONCLUSIONS: In the period 2022-2024 almost 4 in 5 oncology applications discussed by HSE Drugs Group in Ireland were reimbursed. Data packages and commercial offers appear to be largely acceptable in that a decision can be made in the majority of cases with one consideration by Drugs Group.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA30
Topic
Health Policy & Regulatory, Health Technology Assessment, Real World Data & Information Systems
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology