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.
Presentation Documents
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