Role of industry in drug ‘delays’ should be acknowledged

Irish Medical Organisation, Annual General Meeting, The Europe Hotel and Resort, Killarney, Co Kerry, 24-26 April 2025

The timetable for access to new drugs in Ireland is “significantly” influenced by decisions made by the pharmaceutical industry, according to Prof Michael Barry, Clinical Director of the National Centre for Pharmacoeconomics (NCPE).

Prof Barry was speaking on access to medicines during a ‘hot topics’ session at the IMO AGM in Killarney, Co Kerry.

According to Prof Barry, delays in accessing cancer and rare disease treatments are heavily influenced by the time taken by industry to apply for pricing and reimbursement, as well as delays in engaging with the health technology assessment process and subsequent pricing negotiations.

He said doctors and organisations often raised concerns about the HSE’s role regarding delays in the process. However, he said these complaints were often unfair.

Asked by the Medical Independent (MI) whether doctors and representative organisations should raise the role of the industry in delays, Prof Barry said: “I do.”

“I think some of the debate has been disingenuous,” he told MI following his address. “I think it needs to be mentioned more and acknowledged.”

He agreed that the drugs assessment process “takes time”, noting it can “be six to eight to nine months”.

“But you have got to ask where are the other delays coming from? And they are coming from the launching strategies of companies,” he said.

Medicines are often launched in larger European countries before Ireland. Prof Barry highlighted that the HSE has “nothing to do” with the decisions of the pharmaceutical industry.

“We can’t influence them,” Prof Barry argued. “I would like there to be a more open debate around access – not just to cancer drugs, all drugs. As you have seen here [during his IMO address], I’ve shown many examples of cancer drugs and drugs for rare diseases where there was a long time to get from EMA [European Medicines Agency] approval to the end of the assessment process. But much of that was actually taken up by the industry.”

Prof Barry told the IMO meeting that drugs for cancers and rare diseases accounted for approximately two-thirds of all medicines assessed and reimbursed. However, these drugs are invariably high-cost treatments, rarely prove cost-effective, and have a significant budget impact, he added.

Prof Barry also warned that Ireland could experience a massive rise in medicines expenditure if a decision is taken to fund weight loss drugs for all those who could likely benefit.

In such a scenario, he said a figure of €10 billion per year was possible. Prof Barry estimated that the State’s current annual drugs bill is approximately €4 billion. A number of weight loss drugs are currently being assessed regarding their suitability for State schemes.

With the development of these drugs, more resources will be required within the HSE to deal with assessments, Prof Barry told this newspaper.

Last year, MI reported on resource constraints in the HSE Corporate Pharmaceutical Unit (CPU). Prof Barry said the situation had since improved. “We did get increased resources, which are always welcome – both in the HSE CPU and indeed ourselves in the NCPE and the Medicines Management Programme and I think we are very grateful for that.”

However, he added: “What I will say, and what you have seen here today, is that the demands are not going away… they’re getting more intense.”

The Friday morning session of the AGM also heard speakers on several other ‘hot topics’.

Dr John Duddy, Consultant Neurosurgeon, Mater Misericordiae University Hospital, Dublin, spoke on “the cost of overdiagnosis and investigation”. He said doctors should reflect on the possible adverse impact of patient overdiagnosis.

Dr Lisa Cunningham, Consultant in Emergency Medicine, Mayo University Hospital, discussed the relationship between doctors and Medical Council. Dr Cunningham said she did not believe the Council was “striking the right balance” between the needs and rights of patients and doctors. A number of doctors spoke from the floor outlining their own unsatisfactory experiences with the Council.

Also, Dr Anna Beug, GP and Assistant Director, North Dublin City GP Training Scheme, addressed a well-attended session on communicating with neurodivergent patients.