OBJECTIVES: In Ireland, the National Centre for Pharmacoeconomics (NCPE) conduct assessments on all new medicines on behalf of the Health Service Executive (HSE). Recommendations are posted online following a rapid review (RR) or RR plus full health technology assessment (HTA). Following confidential price discussions with the HSE, a final reimbursement recommendation is issued. This research aims to evaluate the average time to reimbursement (aTTR) and identify the key factors impacting aTTR.

METHODS: Key reimbursement data was collated in Excel® using publicly available sources from the NCPE and HSE including:

• NCPE assessment dates & recommendation
• HSE reimbursement recommendation
• Date of reimbursement

• Time to reimbursement (TTR)
• RR outcome HTA required
• RR outcome HTA recommended at submitted price
• Drug designation

RESULTS: N=298 assessments with decision outcomes between June 2016-June 2024 were identified (aTTR=748.61 days). 52.01% (n=155) were reimbursed after RR (aTTR=316.84 days), 47.99% (n=143) were reimbursed after HTA (aTTR=909.76 days). For the subsample, aTTR was 683.38 days. 41.3% (n=76) were oncology drugs and 26.63% (n=49) were orphan drugs. Regression analysis shows that HTA recommendation (coefficient=609.97) and orphan drugs (coefficient=73.30) have longer aTTR, while HTA recommendation at the submitted price (coefficient=-476.00) and oncology drugs (coefficient=-55.76) have shorter aTTR. Overall, the variables explain 41.46% of variation in TTR (Adjusted R²=0.4146).

CONCLUSIONS: TTR challenges in Ireland are well documented. aTTR is over 1.5 years for new medicines and often significantly longer. RR outcome is a predictive factor of overall timelines. Oncology and orphan status contribute to the variance in TTR. With the arrival of joint clinical assessments (JCA) for oncology drugs it will be important to see if the requirement for a RR assessment by the NCPE continues into 2025.