• David O'Reilly, Ronan McLaughlin, Cian Ronayne, Anne Marie De Frein, Bojan Macanovic, Ryan W Chu, Sinead A Noonan, Roisin M Connolly, Derek G Power, Richard M Bambury, Seamus O'Reilly, and Dearbhaile Catherine Collins.
• Department of Medical Oncology, Cork University Hospital, Wilton, Co. Cork, Republic of Ireland. oreilld8@tcd.ie.
• Ir J Med Sci. 2023 Apr 1; 192 (2): 541548541-548.

Introduction/AimsThere are disparities in the availability of systemic anticancer therapies (SACTs) globally. We set out to investigate the cost and reimbursement of SACTs in the United Kingdom (UK) and the Republic of Ireland (ROI) in conjunction with efficacy and licensing authority decisions in the United States (US) and the European Union (EU).MethodsWe sought data pertaining to licensing in the EU, reimbursement in ROI/UK and cost/efficacy of SACTs licensed by the Food and Drug Administration (FDA) between January 2015 and May 2021. Independent samples t tests, chi-square test and Pearson's correlation were used for statistical analysis.ResultsWe identified that the majority of FDA-approved regimens are licensed by the European Medicines Agency (EMA) (n = 91, 67.9%). However, only a minority of these are currently reimbursed in the UK (n = 60, 45%) or the ROI (n = 28, 21%) as of the 1st of May 2021. In addition, only a minority of regimens have demonstrated a statistically significant OS benefit (n = 54, 40%). There was no association between cost of regimens and either the presence (t = 0.846, p = 0.40) or duration of OS benefit (t =  - 0.84, p = 0.64).ConclusionsOur study highlights that many licensed systemic anticancer treatments are not currently reimbursed in ROI/UK. The high cost of these medicines is independent of the presence of an OS benefit. Collaboration between regulatory agencies, governments and industry partners is needed to ensure health expenditure is directed towards the most effective treatments.© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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