Ireland’s spending on medicines is ‘stable’ as patient access challenges persist, says IPHA
Ireland’s spend on medicines as a proportion of overall health expenditure is below the average of 15 other European countries, according an industry analysis of official Irish figures, alongside an international study.
However, some countries that spend roughly the same proportion of their health budgets on medicines are much faster in making the latest treatments available to patients.
Last year, the State spent €2.54 billion on medicines, pharmacy and wholesaling costs – 13.4% of the overall health budget of almost €19 billion – according to estimated figures from Irish Government Economic Evaluation Service in the Department of Public Expenditure and Reform.
A new study by health analysts IQVIA for EFPIA, the biopharmaceutical industry’s representative organisation in Europe, called ‘Understanding Net Pharmaceutical Expenditure Dynamic in Europe’, shows that spending on medicines in 15 European countries is around 15% of total healthcare expenditure.
The surveyed countries were Norway, UK, Sweden, Demark, Slovenia, Belgium, Ireland, Croatia, France, Italy, Germany, Spain, Hungary, Bulgaria and Czechia.
The IQVIA analysis shows that Belgium, France, Italy, Germany and Spain spend between 14% and 18% of their overall health expenditure on medicines. But all of these countries are, on average, faster than Ireland in making new medicines available to their patients.
Belgium is seven days faster, France is 44 days faster, Italy is 112 days faster, Germany is 408 days faster and Spain is 24 days faster. The figures are from the latest EFPIA Patient WAIT Indicator Survey which measured time to reimbursement of medicines newly authorised by the European Medicines Agency.
In the survey, Ireland places 24th out of 35 countries reporting data for time to availability for 160 innovative new medicines, with an average of 541 days to reimbursement.
In 2016, the State spent €1.9 billion on medicines while the overall health budget was €13.5 billion.
That means, based on current Government health expenditure estimates for 2021, we are spending almost 1% less on medicines today than we did five years ago as a proportion of the overall health budget.
EFPIA’s study finds that spending on medicines has been ‘stable’ as a share of total healthcare expenditure in surveyed countries for the past 20 years.
“In that period, the innovation pipeline has been strong,” said a spokesperson for the Irish Pharmaceutical Healthcare Association, the organisation representing the research-based biopharmaceutical industry.
“But even when spending on medicines as a proportion of overall health expenditure is roughly in line with other western European countries, Ireland is much slower to make the latest treatments available to patients. Through sustained Government investment and the new supply Agreement, Ireland should aspire to be among the fastest countries in Europe to adopt innovative new medicines.
“New lines of cancer medicines like targeted therapies and immunotherapies are improving patient outcomes. Hepatitis C medicines are curing patients and, sometimes, replacing liver transplants. Many rare diseases, which previously had no treatments, can now be managed. Despite these breakthroughs, spending on medicines in many European countries, including Ireland, has been stable.”
The EFPIA study finds that overall healthcare expenditure has been growing faster than medicines expenditure. It argues that health systems have a long-term sustainability problem driven by ageing populations and the burden of chronic disease and multi-morbidity.
“For many chronic diseases like diabetes and cardiovascular disease, the cost of medicines is a very small part of the overall cost of the disease, especially if you count the broader societal costs. Medicines reduce unnecessary emergency visits, hospitalisations and complications.
“The recent visit to Dublin by Emily Whitehead, the first paediatric patient in the world to receive a CAR-T, shows the impact of innovation. Emily, who had a rare cancer, is now 17. Some advanced therapies, like CAR-T, come with high upfront costs. But they
could off-set a lifetime of chronic treatment.
“That means they have long-term value – both for the patient and for the health system that pays for them. We need new payment models that are suitable for this new paradigm. These challenges can only be cracked through multi-stakeholder dialogue, especially between industry, State patients and doctors,” said the IPHA spokesperson.
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