Overview: A Third of New Cancer Drugs Improve Survival
Recent discussions at a conference on medicines in Ireland highlighted a striking paradox: while new cancer drugs hold promise, only about a third demonstrably extend overall survival for patients. The head of the National Centre for Pharmacoeconomics warned that many cancer therapies—even those approved—do not translate into longer lives for most recipients. This reality sits at the heart of Ireland’s ongoing efforts to balance patient access, clinical benefit, and the sustainability of medicines funding.
Why Value for Money Matters
The centre evaluates whether new medicines represent value for money for the Health Service Executive (HSE). In an era of high drug costs, with some cancer treatments exceeding 0,000 per patient per course, the value assessment is not merely about efficacy but also about how a drug’s benefit stacks up against its price. Professor Michael Barry underscored that total drug spend this year could surpass €4 billion, underscoring the pressure on public budgets and the necessity for rigorous decision-making frameworks.
Early Access vs. Systemic Review
Early access to cutting-edge cancer drugs is under consideration, though no firm policy has been adopted. The tension is clear: patients want timely access to new therapies, particularly for aggressive cancers, while the State seeks to ensure that every euro spent delivers meaningful clinical gains. The ongoing discussions aim to chart a middle course where patients can receive promising treatments within an accountable timeline, while the public system upholds prudent stewardship of limited resources.
What the 2025 Review Reveals
Data presented this year show that of the 36 new drugs evaluated for reimbursement in the public system, cancer drugs accounted for 58% of the portfolio. Yet recommendations favored for public availability were made in 77% of those cancer drug cases, suggesting that while not all new therapies meet stringent value criteria, many are still considered worth funding given potential survival benefits and patient need. The five-year budget impact for cancer drugs approved in the first nine months of the year was reported at over €510 million at the stated prices from drug manufacturers. This figure highlights the scale of ongoing financial commitments in oncology and the critical role of pricing negotiations in shaping future access.
Negotiations and the Path Forward
State negotiations with the pharmaceutical industry are actively underway to establish a new four-year deal on medicines. Key topics include enabling accelerated access to new medicines within a statutory 180-day timeframe, and negotiating drug savings that help restrain expenditure while preserving patient access. Reforming how new cancer drugs are evaluated, priced, and reimbursed remains a top policy priority as Ireland seeks to harmonize patient expectations with fiscal realities.
Stakeholders and Implications
Industry voices, such as the Irish Pharmaceutical Healthcare Association, emphasize ongoing engagement and collaboration. Industry representatives argue that high prices often reflect development costs and the value of innovation, but they acknowledge the necessity of constructive dialogue around affordability and access. For clinicians and patients, the net effect of these debates is a clearer pathway to understanding which new medicines will be funded and how quickly they can reach the people who need them most.
Key Takeaways for the Public
– A sizeable portion of new cancer drugs do not show a survival advantage, yet many are funded due to other benefits like symptom relief or progression-free survival.
– The public budget for medicines remains under intense scrutiny as cancer drugs represent a growing share of expenditure.
– Reforms aim to speed patient access to promising therapies while ensuring value for money through robust pharmacoeconomic assessments.
– The end goal is a transparent, sustainable framework that balances patient urgency with fiscal responsibility, ideally concluding with a new four-year deal by year’s end.
