Use of the ESMO-Magnitude of Clinical Benefit Scale to Guide HTA Recommendations on Coverage and Reimbursement for Cancer Medicines in Ireland: A Retrospective Analysis
Author(s)
Amy Wall, M.Sc.1, Amanda Henry, M.Sc.2.
1AstraZeneca Ireland, Dublin 15, Ireland, 2AstraZeneca Ireland, Dublin, Ireland.
1AstraZeneca Ireland, Dublin 15, Ireland, 2AstraZeneca Ireland, Dublin, Ireland.
OBJECTIVES: The National Centre for Pharmacoeconomics (NCPE) makes recommendations at a national level for medicines. A 2024 LSE paper found that a high ESMO-MCBS score increased the likelihood of faster positive decisions from HTA agencies in England, Scotland, Australia, France and Canada. This research aims to explore whether a score of 4 or 5 decreases time to positive HTA outcomes versus a score of less than 4 within the Irish context. We will also look at whether having a score of greater than 4 indicating a high clinical need always leads to reimbursement.
METHODS: In this retrospective analysis, data were extracted from publicly available HTA reports and related sources from the NCPE website. We included immunotherapies for treating solid tumours in a non-curative setting with published ESMO-MCBS scores that had been assessed by the NCPE between Jan 1, 2011, and Dec 31, 2023. We analysed whether ESMO-MCBS was associated with the time between rapid review submission and reimbursement in Ireland, and factors associated with positive HTA outcomes.
RESULTS: ESMO-MCBS scorecards encompassing 82 medicine-indication pairs used in non-curative settings were extracted, totalling 35 rapid review submissions. 23 full HTA submissions were reviewed by the NCPE, with 15 medicine-indication pairs receiving reimbursement. 9 medicine-indication pairs were not recommended for reimbursement due to price, 7 of which had a ESMO-MCBS of 4 or 5. Time from rapid review submission to reimbursement of medicines with an ESMO-MCBS of three or less was an average of 789 days, while medicines with an ESMO-MCBS of 4 or 5 averaged 711 days.
CONCLUSIONS: A high ESMO-MCBS score shortened the interval between rapid review submission and reimbursement in Ireland. Additionally, price was a key factor informing the likelihood of reimbursement of immunotherapies with high ESMO-MCBS.
METHODS: In this retrospective analysis, data were extracted from publicly available HTA reports and related sources from the NCPE website. We included immunotherapies for treating solid tumours in a non-curative setting with published ESMO-MCBS scores that had been assessed by the NCPE between Jan 1, 2011, and Dec 31, 2023. We analysed whether ESMO-MCBS was associated with the time between rapid review submission and reimbursement in Ireland, and factors associated with positive HTA outcomes.
RESULTS: ESMO-MCBS scorecards encompassing 82 medicine-indication pairs used in non-curative settings were extracted, totalling 35 rapid review submissions. 23 full HTA submissions were reviewed by the NCPE, with 15 medicine-indication pairs receiving reimbursement. 9 medicine-indication pairs were not recommended for reimbursement due to price, 7 of which had a ESMO-MCBS of 4 or 5. Time from rapid review submission to reimbursement of medicines with an ESMO-MCBS of three or less was an average of 789 days, while medicines with an ESMO-MCBS of 4 or 5 averaged 711 days.
CONCLUSIONS: A high ESMO-MCBS score shortened the interval between rapid review submission and reimbursement in Ireland. Additionally, price was a key factor informing the likelihood of reimbursement of immunotherapies with high ESMO-MCBS.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA351
Topic
Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure
Disease
Oncology