THE LAST MILE OF ACCESS: FIRST-USE ADOPTION OF INNOVATIVE HOSPITAL MEDICINES AFTER NATIONAL FUNDING APPROVAL IN PORTUGAL
Author(s)
Diogo Marques, PharmD1, Manuel Paiva Bento Néry, MSc1, Nuno Picado, Master1, Hugo Pedrosa, MBA, MSc2.
1IQVIA, Lisbon, Portugal, 2Principal, IQVIA Real World Solutions, Lisbon, Portugal.
1IQVIA, Lisbon, Portugal, 2Principal, IQVIA Real World Solutions, Lisbon, Portugal.
OBJECTIVES: National funding approval is a key milestone but may not translate immediately into hospital-level use. This study assessed first-use adoption of innovative hospital medicines in Portugal after INFARMED approval and described variation by hospital cluster and access pathway.
METHODS: Exploratory retrospective analysis used IQVIA Hospital Panel, covering 85% of pharmaceutical consumption in NHS hospitals in mainland Portugal and including 29 institutions, from January 2018 to January 2026. Hospital medicines approved by EMA between 2020 and 2023 and assessed by INFARMED for public funding were screened. First-use adoption was defined as the first observed consumption after INFARMED approval. Hospital eligibility was approximated by previous consumption within the same ATC4 group. Time to first use was calculated from the approval date to the midpoint of the first month of observed consumption.
RESULTS: Of 70 assessed hospital drugs, 60 received positive funding and 57 had at least one month of post-approval consumption history. Among these, 55 had consumption in at least one hospital, corresponding to 96% observed availability within the panel. On average each hospital had a first-use adoption of 46% (median: 45%) of the hospital drugs available, ranging from 14% to 96%. University and oncology hospitals showed the highest adoption rates, at 76% and 77%, respectively. Median time to first use was 178 days. Median times ranged from 13 days in oncology hospitals to 240 days in lower-adoption clusters. Higher adoption rates were associated with shorter observed times to first use. Medicines with prior early access schemes appeared to have shorter times to first use.
CONCLUSIONS: National funding approval did not translate into immediate or uniform hospital-level use. Substantial variation was observed in first-use adoption and time to first use. Monitoring the post-funding “last mile” may help distinguish national availability from local implementation and identify opportunities to improve timely adoption of innovative medicines across hospitals.
METHODS: Exploratory retrospective analysis used IQVIA Hospital Panel, covering 85% of pharmaceutical consumption in NHS hospitals in mainland Portugal and including 29 institutions, from January 2018 to January 2026. Hospital medicines approved by EMA between 2020 and 2023 and assessed by INFARMED for public funding were screened. First-use adoption was defined as the first observed consumption after INFARMED approval. Hospital eligibility was approximated by previous consumption within the same ATC4 group. Time to first use was calculated from the approval date to the midpoint of the first month of observed consumption.
RESULTS: Of 70 assessed hospital drugs, 60 received positive funding and 57 had at least one month of post-approval consumption history. Among these, 55 had consumption in at least one hospital, corresponding to 96% observed availability within the panel. On average each hospital had a first-use adoption of 46% (median: 45%) of the hospital drugs available, ranging from 14% to 96%. University and oncology hospitals showed the highest adoption rates, at 76% and 77%, respectively. Median time to first use was 178 days. Median times ranged from 13 days in oncology hospitals to 240 days in lower-adoption clusters. Higher adoption rates were associated with shorter observed times to first use. Medicines with prior early access schemes appeared to have shorter times to first use.
CONCLUSIONS: National funding approval did not translate into immediate or uniform hospital-level use. Substantial variation was observed in first-use adoption and time to first use. Monitoring the post-funding “last mile” may help distinguish national availability from local implementation and identify opportunities to improve timely adoption of innovative medicines across hospitals.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA138
Topic
Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure
Disease
No Additional Disease & Conditions/Specialized Treatment Areas