OBJECTIVES:

As part of the two-part Irish reimbursement process, companies may be required to submit health technology assessments (HTAs) to the National Centre for Pharmacoeconomics (NCPE); the agency commissioned by the Irish Health Service Executive (HSE). The NCPE HTA summary report details key cost-effectiveness and budget-impact results, considering both the applicant company and NCPE-preferred assumptions.

This research explores incremental cost-effectiveness ratio (ICER) and net budget impact (NBI) results reported by applicants and corresponding NCPE-adjusted results, focussing specifically on differences between oncology and non-oncology medicines.

METHODS:

A database was created in Excel®, collating all relevant cost-effectiveness and budget-impact results from NCPE HTA reports published between January 2020-March 2022 for reimbursed medicines. A comparison was conducted between oncology and non-oncology medicines to determine variance in both reported ICER’s and NBIs.

RESULTS:

47 medicines reimbursed following an HTA were identified, of which 62% (29) were oncology products. The average company-submitted ICER for oncology products was €69,124 (median-€60,174), compared to the NCPE-adjusted ICER of €115,279 (median-€97,190) . The average non-oncology ICER was €131,902 (median-€42,302) and €256,553 (median-€79,743) for the company and NCPE, respectively. Oncology submissions reported an average NBI of €13,081,625 compared to €30,228,561 for non-oncology products.

CONCLUSIONS:

Health systems are now placing an emphasis on making novel oncology products available, which are often high-cost and treat a small patient population. Preliminary results of this analysis show a significant discrepancy between company and NCPE ICERs. Average ICERs for non-oncology products were significantly higher than oncology submissions, however this is likely due to several extreme outliers (as shown by variation in mean and median results). Similarly, average NBIs were higher for non-oncology products, possibly reflecting the smaller patient populations for oncology treatments. The final element of this research explores this relationship further and examines the link between NCPE assessment outcomes and final reimbursement recommendations.