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Budget 2024: delays and deterioration in patients’ outcomes result of no fresh funding for new innovative medicines

By Irish Pharmacist - 02nd Nov 2023

Scientific innovation has advanced significantly over the past number of years bringing new hope and therapies to patients around the globe but, as a result of Budget 2024, patients in Ireland may now have to wait even longer for these new medicines, the Irish Pharmaceutical Healthcare Association has said. It added that the government needs to guarantee an uninterrupted flow of new medicines to Irish patients throughout 2024.

Commenting on the absence of any funding for new medicines in Budget 2024, the Irish Pharmaceutical Healthcare Association said: “In 2024 our member companies plan to launch new medicines across many types of cancers, cardiovascular diseases, HIV, auto-immune diseases, dermatology, kidney disease, musculoskeletal diseases for children and more. These new medicines include the continuous development and extension of existing treatments for diseases such as cancer.

“Without new treatment options, Irish patients will have lower standards of care, disappointed hopes and greater disease progression.

“The budget decision appears to mean that the availability of these new medicines depends on other new savings being realised in-year by the HSE over and above the savings being delivered by IPHA members. This is not a good basis to plan for new treatments. It will lead to delays, uncertainty and backlogs, as before. In short, it risks avoidable deterioration in the conditions of many patients, adults and children included.”

Budget 2024 has effectively interrupted the normal flow of new exchequer funding for new medicines. Despite the absence of allocated new exchequer funding, the Ministers for Health and Public Expenditure and Reform need to make it explicitly clear to the HSE that it can continue to approve and reimburse new medicines from next January onwards.

IPHA Chief Executive Oliver O’Connor said: “New medicines are not ‘nice to have’, they are essential for the practice of medicine and improving standards of care for patients. Our goal is a continuous, steady flow of new medicines, integrating innovation into care pathways so that Ireland will follow the best standards of care.

“IPHA member companies are already providing savings headroom to fund these new medicines. They have implemented a range of price cuts and rebates under the 2021 Framework Agreement for the Supply and Pricing of Medicines. Just two years into this four-year Agreement, IPHA members have delivered €400m in savings to the HSE. This is more than what was expected. It compares with the overall saving of between €600-€700m anticipated by the Minister for Health over the four-year period.”

Over the past three budgets, we acknowledge that the government had made a clear statement that they value the provision of new medicines innovation continually to patients by allocating almost €100m, enabling access to over 120 new medicines or line extensions.

Public spending on medicines directly impacts patient care. Access to these newly available medicines has had a positive impact on the lives of thousands of Irish patients suffering from many different diseases.

Spending on medicines accounts for 15% of the overall health budget, a normal level within Europe. On a per capita basis, Ireland’s health spending is not at all out of line, being ninth in the EU. Across all health spending, new medicines expenditure is among the most robustly assessed. Budget-impact medicines go through a strict evaluation process to determine if they will improve efficiency and standards of care before being made directly available to Irish patients.

Michael O’Connell, President of IPHA, said we cannot repeat the stop-start funding for new medicines experienced in the past: “Four years ago, the government allocated no funding for new medicines in Budget 2020. This resulted in a backlog of medicines, causing uncertainty and unpredictability. It also meant that Budget 2021 required an over-allocation of funding to deal with the backlog of medicines which had built up in the system. The backlog and delays were clearly bad for standards of care for patients and very frustrating for clinicians and all involved.

“Earlier this year IPHA welcomed Minister Donnelly’s decision to publish the Mazars report and to establish a working group to review and improve the reimbursement system for new medicines. As an association we have engaged fully with this process and will continue to collaborate and engage to improve the current system. However, without an assurance by the government of an uninterrupted flow of new medicines in 2024, the recommendations of the Mazars report, when implemented, will still fail to deliver the latest treatments to Irish patients. The Ministers for Public Expenditure and Reform and Health have it in their hands to avoid this, we urge them to act,” said Mr O’Connell.

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