Expenditure on high-tech medicines continued to increase last year despite State containment efforts.
More than €1.146 billion was paid to manufacturers/wholesalers of high-tech drugs compared to €1.064 billion in 2022. The patient care fees to community pharmacists rose from €40.92 million to €45.87 million, according to the Primary Care Reimbursement Service Statistical Analysis of Claims and Payments 2023.
High-tech medicines were dispensed to over 125,000 people compared to approximately 113,000 in 2022. These specialised medicines are usually prescribed for long-term illnesses including cystic fibrosis, cancers, and rheumatoid arthritis.
In 2023, more than €879 million of the expenditure was on antineoplastic and immunomodulating agents. The next highest spend was €89.55 million on respiratory drugs.
Meanwhile, the value of high-tech medicine stock on-hand at pharmacies has remained at a similar level. In 2023, the value of this stock was €41 million and in 2022 it was €42 million.
Last year, the value of high-tech medicine stock, which did not have an active patient, was €13.7 million compared to €12 million in 2022. The value of out-of-date stock has remained at around €2.5 million annually for several years.
According to the Review of High-Tech Drug Expenditure (2021), high-tech drugs were the primary driver of increasing pharmaceuticals expenditure. The introduction of new higher cost medicines, and growth in patient volume, were cited as reasons for the rising spend. This growth was partially offset by agreed price reductions with industry and the introduction of cost-reducing treatments, such as generic or biosimilar options, according to the review.
A Department of Health spokesperson told the Medical Independent that over €3 billion was spent on medicines in 2023. This equated to nearly €1 in every €8 of health funding.
In 2024, the HSE reimbursed 16 new medicines including six for cancer treatment and seven orphan drugs for rare diseases.
The area of medicines expenditure is included in the remit of the productivity and savings taskforce, which was established in January 2024. The medicines sustainability taskforce is charged with driving “immediate savings” and progressing “medium- to long-term structural reform” in medicines expenditure.
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