Market Access in Ireland

The market access process in the Republic of Ireland differs from the UK in many ways.

Market Access Overview

Sample information taken from our MAP Ireland section

In the Republic of Ireland, a company needs to answer the following questions in advance of making a submission to the Irish authorities:

  1. Which of the 14 countries in Ireland’s ‘reference basket’ currently or will in the future influence your product’s price?
  2. Will health economic evaluation of your product demonstrate cost-effectiveness with reasonable certainty at a threshold of €45,000 per Quality Adjusted Life Year (QALY) gained?
  3. What is the commercial plan if current data does not currently demonstrate cost effectiveness at this threshold?
    • For example, could an access scheme based on risk sharing or more simple rebate or discount be considered by the company?

Drug Reimbursement Schemes

The main reimbursed drug schemes are:

  • General Medical Service (GMS) Scheme – patients are issued a Medical Card which entitles them to a range of Health Services free of charge. A €2.00 charge applies to all prescription medicines (reduced to €1.50 for patients over 70 years old), up to a maximum charge of €20.00 per family HSE – reimbursed drugs list
  • Drugs Payment Scheme (DPS) – individuals and families do not have to pay above a monthly threshold of €124 (reduced from €134 as of April 2019, HSE) – reimbursed drugs list
  • Long-Term Illness Scheme (LTIS) – people suffering certain chronic conditions (see the HSE LTIS page for a list of all the diseases included) are entitled to full drug reimbursement free of charge, irrespective of income
  • High Tech Drugs Scheme (HTDS) – facilitates the supply of high-cost medicines, which are normally only prescribed or initiated in hospitals, through community pharmacies with co-payments of €124 per family unit – reimbursed drugs list
  • Hospital only – commissioned by hospitals and paid for from their overall budget

Reimbursement Process

All approved drugs under the Community Drug Schemes are 100% reimbursed with the exception of the DPS (drug payment scheme) where a maximum co-payment of €100 per family per month exists.

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