Ireland may be a world leader in the manufacture of innovative new medicines but getting them to the patients who need them can be a challenge, according to Andres Rodrigo, general manager Ireland at AbbVie.
“At this very moment many thousands of research and development colleagues of mine are working in partnership with patients and doctors around the world in search of breakthrough medicines,” he says. “They are applying cutting-edge science, including AI, and forensically examining illnesses at a molecular level to better understand what drives diseases. Their goal is a big one – creating first-in-kind medicines with the power to genuinely transform people’s lives.”
He says many companies choose to manufacture new treatments in this country. “Ireland is home to more than 90 pharmaceutical plants and exports €116 billion worth of medicines every year. This puts us in the world’s top 10 pharmaceutical manufacturing countries. But delivering for society is not just about researching and manufacturing medicines. It’s imperative that countries also have an efficient system in place to ensure their citizens get fast access to life-extending or life-enhancing treatments.”
That issue was addressed recently by Sharmila Nebhrajani, chair of the UK National Institute for Clinical Excellence, the body that assesses medicines in England, Wales and Northern Ireland. “Speed matters most because the opportunity cost of any delay is not zero. Patients are waiting on life-saving treatments and innovative medicines to make a difference to their lives.
“Ireland is slower at making new medicines available for patients locally than our 13 closest neighbouring countries in western and northern Europe,” says Rodrigo. “All new medicines must demonstrate cost benefit value before they are approved by the Irish State. In recent years the health services have been implementing a range of measures – including a partnership supply agreement with the pharmaceutical industry – designed to maximise value from pharmaceutical spending and free up budget for newer treatments. And this has delivered significant savings. Whilst Ireland was the third highest spending EU country on pharmaceuticals in 2012, eight years later we were spending less than the EU27 average.”
The good news is that improving patient access to new medicines in Ireland is definitely possible. “Two key actions can begin delivering immediate benefits.” says Rodrigo. “The first involves successive governments ensuring that dedicated multiannual funding for new medicines becomes predictable and sustained. Ireland allocated €50 million to new medicines in 2021. But this fell to €30 million in 2022. In 2023 the budget fell again to €18 million, and in 2024 no budget was initially allocated. When doctors, pharmaceutical companies, media, and individual politicians raised concerns, €20 million was subsequently made available via supplementary estimates.
“We must not repeat the error of last year. The healthcare allocation in the coming budget – and all those that follow it – must contain ring-fenced, stable funding for new medicines. This budgetary provision should be based on patient-focused need.”
He says the second step involves following through on the Minister for Health’s plans to appoint 34 new employees to national medicines’ agencies. “We have just half the numbers of dedicated staff undertaking this work compared with peer healthcare systems such as Scotland or Sweden. These appointments were approved six months ago but have not been filled. Indeed, only four of the 34 posts have been advertised to date. The HSE recruitment embargo has been lifted. These roles should be advertised immediately and filled quickly. Patients in need are waiting for key decisions on new medicines to be made. More people in place will help ensure that these decisions can be made faster.”
Rodrigo believes it is correct for Ireland to be prudent in terms of health system resource provision and spending. “Robust, predictable processes, accountability and transparency on all sides will support good decision-making. A recent review, undertaken by Mazars for the Government, highlighted the need to ensure patients have better clarity on which new medicines are under review, and how these applications are progressing. This will ensure that patients, doctors and companies have visibility of what innovative new medicines are under HSE review, and when those reviews are likely to progress to completion. I am confident that together we can make this a reality.
“Establishing a new system that ensures patients get faster access to new medicines will deliver value for Ireland because outcomes and long-term standards of care will improve as a direct result. And Ireland, a medicines manufacturing powerhouse, will begin to catch up with peer European countries who are currently faster than us when it comes to making the latest medicines available to their citizens.”