National Centre for Pharmacoeconomics

National Centre for
Pharmacoeconomics

NCPE Ireland

The terminology used in NCPE recommendations is explained below. The NCPE publish the outcomes of the Rapid Reviews and full Health Technology Assessments (HTAs) on the NCPE website, under the ‘Pharmacoeconomic Evaluations’ tab. Queries on the reimbursement process and next steps once a recommendation has been issued should be directed to the HSE CPU at cpu@hse.ie.

Conclusions to Rapid Reviews

 


NCPE Rapid Review Conclusion

Plain language interpretation
 
A full HTA is recommended to assess the clinical effectiveness and cost effectiveness of [Drug] compared with the current standard of care.

 

The NCPE has completed a Rapid Review for this medicine. The outcome of this Rapid Review is that, it is not clear that the drug offers value for money compared to other currently available medicines. A full assessment (HTA) is therefore required in order for the NCPE to make a recommendation to the HSE on whether or not to reimburse this medicine.

 

A full HTA is recommended to assess the clinical effectiveness and cost effectiveness of [Drug] compared with the current standard of care, on the basis of the proposed price relative to currently available therapies. The NCPE has completed a Rapid Review for this medicine. The outcome of this Rapid Review is that, it is not clear that the drug offers value for money based on the current price, compared to other currently available medicines.

 

A full assessment (HTA) is therefore required in order for the NCPE to make a recommendation to the HSE on whether or not to reimburse this medicine.

 

A full HTA is not recommended. The NCPE recommends that [Drug] be considered for reimbursement. This recommendation should be considered while also having regard to the criteria specified in the Health (Pricing and Supply of Medical Goods) Act 2013. The NCPE has completed a Rapid Review for this medicine. The outcome of this Rapid Review is that, there are no major concerns with the efficacy of and/ or value for money associated with this medicine when compared to other medicines. The NCPE recommends that a full assessment (HTA) is not required and the HSE should consider reimbursing this medicine.

 

When making a decision on whether to reimburse this medicine, the HSE will consider the NCPE’s recommendation on clinical and cost-effectiveness, along with additional criteria which are outlined in the Health Act 2013.

 

A full HTA is not recommended. The NCPE recommends that [Drug] not be considered for reimbursement at the submitted price. This recommendation should be considered while also having regard to the criteria specified in the Health (Pricing and Supply of Medical Goods) Act 2013. The NCPE has completed a Rapid Review for this medicine. The outcome of this Rapid Review is that, there is strong evidence that this medicine at its current price is not value for money when compared with other medicines. The NCPE recommends that a full assessment (HTA) is not required and that the HSE should consider not reimbursing the medicine unless a price discount can be agreed.

 

When making a decision on whether to reimburse this medicine, the HSE will consider the NCPE’s recommendation on clinical and cost-effectiveness, along with additional criteria which are outlined in the Health Act 2013.

 

A full HTA is not recommended until additional efficacy and/or safety data is submitted. On the basis of current evidence, the NCPE recommends that [Drug] not be considered for reimbursement, having regard to the criteria specified in the Health (Pricing and Supply of Medical Goods) Act 2013. The NCPE has completed a Rapid Review for this medicine. The outcome of this Rapid Review is that, there is not enough evidence to assess if this medicine is an effective treatment and/or the NCPE consider this medicine does not demonstrate value for money when compared with other currently available medicines. The NCPE expect further evidence will become available in the near future which will allow assessment of this medicine. The NCPE have therefore concluded that a full assessment (HTA) is not currently recommended and that the HSE should consider not reimbursing the medicine at this time.

 

When making a decision on whether to reimburse this medicine, the HSE will consider the NCPE’s recommendation on clinical and cost-effectiveness, along with additional criteria which are outlined in the Health Act 2013.

 

 

Conclusions to Health Technology Assessments

 

NCPE HTA Recommendation Plain language interpretation
The NCPE recommends that [Drug] be considered for reimbursement. This recommendation should be considered while also having regard to the criteria specified in the Health (Pricing and Supply of Medical Goods) Act 2013. The NCPE assessment has concluded that, there is strong evidence that this medicine is a clinically effective treatment and are satisfied that the economic case presented by the company is adequate for assessing the value of this medicine. The NCPE consider this medicine demonstrates value for money relative to other currently available medicines.  The NCPE have therefore recommended that the HSE should consider reimbursing the medicine.

 

When making a decision on whether to reimburse this medicine, the HSE will consider the NCPE’s recommendation on clinical and cost-effectiveness, along with additional criteria which are outlined in the Health Act 2013.

The NCPE recommends that [Drug] be considered for reimbursement if cost-effectiveness can be improved relative to existing treatments. This recommendation should be considered while also having regard to the criteria specified in the Health (Pricing and Supply of Medical Goods) Act 2013. The NCPE assessment has concluded that, there is strong evidence that this medicine is a clinically effective treatment and are satisfied that the economic case presented by the company is adequate for assessing the value of this medicine. However, the NCPE consider this medicine may not demonstrate value for money relative to other currently available medicines at the present price. The NCPE have therefore recommended that the HSE should only consider reimbursing the medicine at a price discount.

 

When making a decision on whether to reimburse this medicine, the HSE will consider the NCPE’s recommendation on clinical and cost-effectiveness, along with additional criteria which are outlined in the Health Act 2013.

The NCPE recommends that [Drug] not be considered for reimbursement unless cost effectiveness can be improved relative to existing treatments. This recommendation should be considered while also having regard to the criteria specified in the Health (Pricing and Supply of Medical Goods) Act 2013. The NCPE assessment has concluded that:

 

(i)                 there is strong evidence that this medicine is a clinically effective treatment and are satisfied that the economic case presented by the company is adequate for assessing the value of this medicine. However, the NCPE consider this medicine does not demonstrate value for money relative to other currently available medicines at the present price. The NCPE have therefore recommended that the HSE should consider not reimbursing the medicine unless a price discount can be agreed.

 

(ii)               there is some evidence that this medicine is a clinically effective treatment and are satisfied that the economic case presented by the company is adequate for assessing the value of this medicine. However, the NCPE consider this medicine does not demonstrate value for money relative to other currently available medicines at the present price. The NCPE have therefore recommended that the HSE should consider not reimbursing the medicine unless a price discount can be agreed.

 

When making a decision on whether to reimburse this medicine, the HSE will consider the NCPE’s recommendation on clinical and cost-effectiveness, along with additional criteria which are outlined in the Health Act 2013.

The NCPE recommends that [Drug] not be considered for reimbursement. This recommendation should be considered while also having regard to the criteria specified in the Health (Pricing and Supply of Medical Goods) Act 2013. The NCPE assessment has concluded that, either there is insufficient evidence that this medicine is a clinically effective treatment, or the NCPE is not satisfied that the economic case presented by the company is adequate for assessing the value of this medicine. The NCPE consider this medicine does not demonstrate value for money relative to other currently available medicines. The NCPE have therefore recommended that the HSE should consider not reimbursing the medicine.

 

When making a decision on whether to reimburse this medicine, the HSE will consider the NCPE’s recommendation on clinical and cost-effectiveness, along with additional criteria which are outlined in the Health Act 2013.