PNS164 PHARMACOECONOMIC ASSESSMENT AND DRUG COSTS OF TREATMENTS FOR CANCER AND RARE DISEASES IN IRELAND

Abstract

Objectives Drug development is increasingly focused on treatments for oncology and rare diseases. This has resulted in rising drug costs with delayed or limited access to these products. This study aimed to compare drug costs for oncology and orphan products with those from other therapeutic areas. Methods Product details from reimbursement submissions to the NCPE were recorded for 2012-2017. The estimated annual/treatment cost per patient and incremental cost effectiveness ratio (ICER) were extracted from the pharmacoeconomic reviews. These indicators for oncology and orphan products (Group A) were compared to all others (Group B) for the study period. The trends for the two groups were also reviewed by contrasting 2012 with 2017. Results 273 reviews were submitted during the study period, excluding repeat submissions, and 103 full health technology assessments (HTA) were commissioned. 108 reviews were for Group A (39.6%) and the majority of HTA’s (62.1%) involved this group. The estimated annual cost per patient for a drug from Group A more than doubled from 2012(€59,500) to 2017(€130,500). A similar increase was apparent for Group B, however, the annual cost for Group A drugs was almost five times higher. This was also reflected in the percentage of Group A drugs (46.3%) with an ICER greater than the Irish Willingness to Pay (WTP) compared to Group B (8.5%). The percentage of Group A drugs which exceeded the threshold increased from 25% to 50% over the study period. Conclusion It is evident from this study that treatments for cancer and rare diseases are considerably more expensive than those from other therapeutic areas. Also, they more frequently require HTA assessment and are increasingly exceeding agreed WTP thresholds. While some countries are addressing these issues, it is necessary to develop health policies at a European level to ensure appropriate access to these medicines.