Presentation (CTI)

OBJECTIVES: In Ireland, reimbursement of new medicines involves health technology assessment by the National Centre for Pharmacoeconomics (NCPE), followed by price negotiations. Long time to reimbursement (TTR) has been consistently reported, including through the EFPIA WAIT Indicator. Following the Mazars Review (2023), additional staffing was introduced, while the 2026 Framework Agreement on the Pricing and Supply of Medicines established a target TTR of 180 days by 2029 and committed to resolving delayed older medicines. This study examined TTR between 2023 and 2026 to establish a baseline against which progress under the Framework Agreement can be assessed.
METHODS: All NCPE evaluations conducted between January 2023 and May 2026 were compiled, including indication, reimbursement status, and reimbursement date. TTR was measured from Rapid Review initiation to reimbursement. Annual NCPE evaluations, reimbursed medicines and indications, and mean TTR were compared across 2023-2026.
RESULTS: The NCPE completed 78, 61, 95, and 39 evaluations in 2023, 2024, 2025, and 2026 to May, respectively. During the same period, 37, 51, 42, and 17 new medicines or indications were reimbursed. Mean TTR decreased from 705 days in 2023 to 678 days in 2024 and 623 days in 2025, indicating modest improvement. However, mean TTR for medicines reimbursed in 2026 increased to 1,067 days, driven by reimbursement of longstanding applications initiated in 2019-2020, including ravulizumab and nivolumab, reflecting backlog clearance rather than routine process performance.
CONCLUSIONS: Ireland showed modest reductions in mean TTR between 2023 and 2025, although timelines remain substantially above the 180-day target. The elevated 2026 TTR reflects legacy applications and should not be interpreted as worsening current performance. These findings provide a baseline for assessing the impact of recent resourcing and policy reforms.