OBJECTIVES: The National Centre for Pharmacoeconomics (NCPE) reviews the cost effectiveness of new medicines following an application for reimbursement in Ireland. All medicines are subjected to a preliminary rapid review (RR, stated to take ~2 weeks) with only high cost products and those with significant budget impact subjected to formal pharmacoeconomic assessments (PEA, stated to be completed in <3 months). This research aims to review all recent NCPE appraisals to determine what proportion of drugs require a full appraisal, the review times and rates of approvals. METHODS: Publically available decision summaries from the NCPE were identified (from 1^st January 2013 to 31^st May 2015) and the outcome, date, indication, and whether a full PEA was needed were extracted. RESULTS: CONCLUSIONS: The total average length of time between start of the RR to final PEA recommendation is up to a year (12 months), which is substantially longer than what is claimed. If companies can convince the NCPE that their medicine is not high cost, nor has a significant budget impact, the RR process can enable rapid reimbursement within 1-2 months. However, if a full PEA is required, this significantly delays reimbursement decisions, with positive recommendations being difficult to achieve, especially for oncology medicines.