Written answers

Thursday, 9 March 2023

Department of Health

Medicinal Products

Photo of Pádraig O'SullivanPádraig O'Sullivan (Cork North Central, Fianna Fail)
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316. To ask the Minister for Health the average length of time it takes to approve an EMA-approved orphan medicine in Ireland, from receipt of application for reimbursement to actual approval; how this compares with EU counterparts; and if he will make a statement on the matter. [12031/23]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Photo of Pádraig O'SullivanPádraig O'Sullivan (Cork North Central, Fianna Fail)
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317. To ask the Minister for Health the average length of time it takes to approve an EMA-approved medicine for reimbursement in Ireland, from receipt of application for reimbursement to actual approval; how this compares with EU counterparts; and if he will make a statement on the matter. [12032/23]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Photo of Pádraig O'SullivanPádraig O'Sullivan (Cork North Central, Fianna Fail)
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318. To ask the Minister for Health the average length of time it takes to approve an EMA-approved cancer drug in Ireland, from receipt of application for reimbursement to actual approval; how this compares with EU counterparts; and if he will make a statement on the matter. [12033/23]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Photo of Pádraig O'SullivanPádraig O'Sullivan (Cork North Central, Fianna Fail)
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319. To ask the Minister for Health if he will outline the research that has been done internally in his Department to analyse or compare how Ireland ranks with EU counterparts for the approval of EMA-approved orphan medicines; and if he will make a statement on the matter. [12034/23]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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The Health (Pricing and Supply of Medical Goods) Act 2013 provides a rigorous process for the assessment of new medicines for reimbursement. This allows taxpayers to be confident both that the right medicines are chosen, and that those medicines are approved at a price that can sustainably be afforded in a budget-limited health service. Economic assessment is valuable to stretch the funds granted to the HSE as far as possible, allowing them to provide a range of services as well as innovative medicines for all citizens.

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority. In line with the 2013 Act, and the national framework agreed with industry, a company must first submit an application to the HSE to have a new medicine added to the reimbursement list.

The timing of company applications for reimbursement in different countries can vary for a number of reasons, not least the available market share in each country. Once a company responsible for the commercialisation of a new medicine receives market authorisation, it can apply for reimbursement in the country (or countries) of its choice. Ireland, by virtue of its size and market share, may not always be prioritised by a company in the first stages of marketing a new product. Describing timelines for reimbursement from EMA approval to HSE reimbursement approval does not consider this important factor and misrepresents the process, as statutorily the HSE would not be able to approve or assess a drug until an application for reimbursement was received.

When an application is made to have a product added to the reimbursement list in Ireland, the HSE is required, under the 2013 Act, to decide within 180 days of receiving the application, to either add the medicine to the reimbursement list or refuse to reimburse the medicine. In assessing the application, the HSE is required to consider a range of criteria including the magnitude of the clinical effect, cost effectiveness, budget impact, opportunity cost and unmet need.

The principal factors in determining the speed of reimbursement are the price at which a manufacturer applies for the reimbursement of a product and the outcome of the HSE’s rigorous assessment process as to its clinical and cost-effectiveness.

In terms of the time taken from application to a decision on reimbursement, the HSE advise that the biggest impediments to achieving the 180-day timeline is often the failure of companies to provide sufficient evidence to support the efficacy of some medicines, and the need for the HSE to get involved in protracted negotiations in seeking to achieve better prices for the State.

The State is committed to providing timely access to new and innovative medicines to all patients. Budget 2021 allocated €50 million for the reimbursement of new drugs, enabling the HSE to approve 52 new medicines. 18 of these medicines had orphan designation.

Budget 2022 allocated a further €30 million for the reimbursement of new medicines allowing the HSE to approve 60 new drugs, 16 of which had orphan designation. Further dedicated funding of €18 million was allocated in Budget 2023.

The pricing and reimbursement of medicines is a national competence. Different pharmaceutical reimbursement systems are currently in place across the EU. As Member States operate different systems, a direct comparison of the reimbursement of products is not possible.

Photo of Pádraig O'SullivanPádraig O'Sullivan (Cork North Central, Fianna Fail)
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320. To ask the Minister for Health the number of EMA-approved orphan drugs that were approved for reimbursement in each of the years 2016 to 2022; the date these drugs were applied for initially, in tabular form; and if he will make a statement on the matter. [12035/23]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Photo of Pádraig O'SullivanPádraig O'Sullivan (Cork North Central, Fianna Fail)
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321. To ask the Minister for Health the number of staff allocated to the National Rare Disease Office; the qualifications of the staff working there; if additional resources will be allocated; and if he will make a statement on the matter. [12036/23]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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A breakdown of the staff employed as whole-time equivalents (WTE) in the National Rare Diseases and their qualifications is set out in tabular form below as of 7March 2023. Any additional funding requests for the National Rare Diseases Office will be considered as part of the Annual Estimates process.

Position WTE Qualifications
Clinical Lead 0.3 MD, FRCPI, FRCPC, FCCMG (Clinical Genetics) Clinical Professor of Medicine of Rare Disorders, TCD; Full Clinical Professor, UCD
Deputy/Asst. Clinical Lead 0.4 Currently vacant – plan to recruit in 2023
Business Manager 1.0 BA HRM; Project Management
Information Scientist 0.9 MSc Genetic Counselling
Information Scientist 0.6 PHD Medical Genetics; MSc Genetic Counselling
Information Scientist 0.4 MSc in Clinical Neuroscience
Information Scientist 0.2 MSc in Clinical Neuroscience
Administrator 1.0 Currently vacant – soon to be filled
Total WTE in post 3.4
Total WTE allocated 4.8

Photo of Pádraig O'SullivanPádraig O'Sullivan (Cork North Central, Fianna Fail)
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322. To ask the Minister for Health the number of genetic consultants employed in Ireland; the plans, if any, to recruit additional consultants specialising in genetics; and if he will make a statement on the matter. [12037/23]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Photo of Pádraig O'SullivanPádraig O'Sullivan (Cork North Central, Fianna Fail)
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323. To ask the Minister for Health the average time expended during the orphan drugs reimbursement process waiting for industry or pharmaceutical companies to revert with additional information that has been requested of them; his views on whether this is a significant factor in the delay of the process; how this can be improved; and if he will make a statement on the matter. [12038/23]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

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