All new products to be reimbursed from the Irish health budget are subject to a rigorous assessment by the National Centre for Pharmacoeconomics (NCPE). Following assessment, a recommendation is made regarding its cost-effectiveness at the submitted price. This may lead a reduction in the drug price. This study aimed to determine the reduction in expenditure due to the pharmacoeconomic assessment process in Ireland.

Product details, submitted price and gross budget impact were recorded for each NCPE submission from 2012 to 2015. The latter was chosen as reimbursement data are currently available until 2016. A product was included if its assessment suggested price reduction was required and the product was reimbursed under the High-Tech Drug Scheme (HTDS), a scheme for high cost drugs in a primary care setting. The utilization and actual expenditure of each product was extracted from national reimbursement data for the year after approval. The expected expenditure, calculated using the submitted price, was then compared to the actual expenditure.

A total of 162 products were assessed during the study period. There was a potential price reduction for 65 products based on the assessment outcome. Of these, 15 were reimbursed under the HTDS. A reduction in expenditure was evident for eight of the 15 products (53 percent). The average reduction was eight percent of the expected expenditure. All products showed an actual expenditure greater the predicted budget impact submitted by the applicant.

To the authors’ knowledge, this is the first report of expenditure reduction due to a pharmaco-economic assessment process. With the ever-increasing utilization of high cost drugs, the study demonstrates the importance of a process to assess and negotiate cost-effective drug prices. However, the study underestimates reductions, as it is yet to include commercial rebates returned to a central budget. Future research will aim to capture these reductions.