OBJECTIVES: Following the September 2006 agreement between the Irish Pharmaceutical Healthcare Association (IPHA) and Health Service Executive (HSE) pharmacoeconomic assessment of technologies that may be of high cost or significant budget impact, may now be requested prior to reimbursement. The aim of this paper is to describe the pharmacoeconomic process in Ireland, currently conducted by the National Centre for Pharmacoeconomics (NCPE). METHODS: The Department of Health & Children (DoHC) determines which technologies will be subject to pharmacoeconomic assessment. Following notification from the DoHC, a preliminary meeting between the NCPE and the relevant pharmaceutical company is arranged, to determine information requirements. Further meetings preceed the submission of a formal cost-effectiveness evaluation. The NCPE then prepares a report based on the company submission. Finally, the company has an opportunity to review the NCPE report, and if necessary, to appeal it. The report is then submitted to the DoHC, where it can be used as an aid to the pricing and reimbursement decision making process. The whole process must take place within a 90 day period. RESULTS: Since the 2006 agreement, approximately 14 evaluations have been carried out by the NCPE, four of which were full economic evaluations of new drugs prior to reimbursement. The time from submission of the NCPE report to reimbursement ranged from 1 to 2 months. Two evaluations to inform public health policy were also conducted (hepatitis B and pneumococcal conjugate vaccines). CONCLUSION: Following recent developments, the demand for pharmacoeconomic evaluation is set to increase. A major strength of this process is the timeliness to the reimbursement decision. The influence on public health interventions is already evident, where both vaccination strategies have been adopted into the routine infant immunisation programme. Evidence also suggests that the evaluation process is having a positive impact on prescribing in primary care.