Pattern of Medicines Reimbursement Recommendations With Health Technology Management in Ireland: 2018-2023

OBJECTIVES: In Ireland, the Health (Pricing and Supply of Medical Goods) Act 2013 established the Reimbursement List and empowered the Health Service Executive (HSE) to add or remove items (medicines, medical and surgical appliances) to the List based on factors such as patient safety, cost-effectiveness, and appropriate use of medicines and available resources. The Drugs Group is an advisory committee charged with recommending medicines for addition to the List. Health Technology Management (HTM), defined as measures put in place to enhance the safe, effective and cost-effective use of medicines post-reimbursement, is provided for under Section 20 of the Health Act. This study reviewed the minutes of meetings of the Drugs Group to explore the trends of positive/conditional positive recommendations by the Drugs Group with HTM.

METHODS: The published minutes of meetings of the Drugs Group from January 2018 to December 2023 were reviewed through content analysis and relevant information was extracted to a Microsoft Excel Spreadsheet. The data was cleaned, deduplicated and analysed with Microsoft Excel for trends in positive/conditional positive recommendations with Health Technology Management (HTM).

RESULTS: The Drugs Groups gave a total of 157 positive/conditional positive recommendations over the study period (n = 26, 23, 20, 33, 27 and 28 in 2018 - 2023). Of these, 33 medicines received a positive/conditional positive recommendation with HTM (four in 2018, 2019 and 2020, eight in 2021 and 2022, and five in 2023). The proportion of positive/conditional positive recommendations contingent on HTM increased year-on-year between 2018 and 2022 before declining in 2023. In 2022, the highest proportion of recommendations with HTM was seen at 29.6%, compared with 15.4% in 2018.

CONCLUSIONS: Our study found an increase in the proportion of positive/conditional positive recommendations with HTM over the study period. Further research is needed to identify potential indicators of reimbursement recommendations with HTM.