UCAN Ireland welcomes the announcement by Jennifer Carroll MacNeill TD of new framework agreements on the pricing and supply of medicines, as outlined in the recent Department of Health press release.
For patients, the most significant element of this announcement is the renewed commitment to deliver reimbursement decisions within 180 days. This represents a major step forward from the reality patients have experienced to date.
A significant shift from the current reality
In oncology, patients in Ireland currently wait an average of 644 days for access to new medicines, according to the EFPIA Wait Indicator. At the same time, only around 25% of innovative oncology medicines approved at European level are available to Irish patients.
The requirement to make reimbursement decisions within 180 days has been set out in legislation since the Health Act 2013, yet this timeline has never been enforced or upheld in practice. Patients and families have instead lived with prolonged delays, uncertainty, and unequal access compared with other European countries.
For that reason, it is welcome to see this issue explicitly acknowledged at Ministerial level. The commitment now made is significant, and we will be watching closely to see it delivered.
Why predictable timelines matter
Reliable reimbursement timelines matter for two key reasons.
First, faster decisions mean faster access where there is clear clinical benefit. Every month of delay represents time lost for patients whose disease does not wait.
Second, predictable timelines make it possible to bridge unmet need. When the assessment and negotiation process is time-bound and transparent, it creates the conditions for early access mechanisms to operate while decisions are underway.
The Minister’s statement refers to the investigation of a pilot early access scheme. While such schemes do not yet form part of the framework agreement, this acknowledgement is important. Early access can only function credibly when timelines are reliable.
Transparency and accountability will be critical
To ensure this commitment translates into real change, transparency will be essential. UCAN awaits updates to the reimbursement tracker so that timelines can be monitored and publicly reported. Without this visibility, it will not be possible to assess whether the 180-day commitment is being met in practice.
Patients have heard commitments before. Delivery is what matters now.
Early access must be designed with patients and clinicians
As discussion begins on a potential early access pilot, UCAN strongly believes that patients and clinicians must be involved in its design and delivery from the outset. Early access schemes must be safe, equitable, and responsive to real clinical need.
We therefore again call on Dr Colm Henry, Chief Clinical Officer, HSE and Prof. Michael Barry, Clinical Director, NCPE to ensure that all relevant stakeholders — including patient organisations and frontline clinicians — are meaningfully included in this work.
A moment of opportunity
This announcement marks a potential turning point. A functioning 180-day decision timeline, combined with transparency and well-designed early access mechanisms, could significantly improve how patients in Ireland experience access to medicines.
UCAN will continue to engage constructively, but robustly, to ensure that this moment of opportunity leads to real, measurable improvements in access for patients who need treatment now.