OBJECTIVES:

The Irish reimbursement process involves several stages, beginning with a formal evaluation by the National Centre for Pharmacoeconomics (NCPE). This evaluation includes a preliminary rapid review (RR) assessment, with some applications requiring a further health technology assessment (HTA). Following NCPE assessment, reimbursement recommendations are made by the Irish Health Service Executive (HSE) Drugs Group. In January 2022, the HSE reported that 52 medicines were reimbursed in 2021. This research analyses the pathway for these medicines and evaluates timelines to reimbursement.

METHODS:

A database was developed in Excel®, mapping the reimbursement pathway for medicines reimbursed in 2021, using publicly-available information from the NCPE and HSE websites. For each medicine identified, details relating to the type of NCPE assessment conducted (RR alone or RR+HTA) and time to reimbursement were extracted (defined as the time from RR submission to published reimbursement date).

RESULTS:

A total of 49 medicines reimbursed by the HSE in 2021 were identified. Of these, 19 were reimbursed following a RR assessment, with 30 requiring a RR and HTA. The average time to reimbursement for a medicine undergoing a RR assessment was 323.53 days, increasing to 947.80 days for applications requiring a RR and HTA. RR assessment took on average 47.00 days in comparison to 262.90 days for an HTA. The average time between NCPE outcome and reimbursement date was 276.53 days for products requiring only a RR, in comparison to 418.13 days following a RR+HTA.

CONCLUSIONS:

This research builds on work previously published by AXIS Healthcare Consulting on Irish reimbursement timelines. For products reimbursed in 2021, the time to reimbursement increased significantly if a HTA submission was required. As well as increasing the duration of the NCPE assessment, additional time was required in the post-NCPE assessment phase, likely reflecting the increased complexity and uncertainty for these products.