Ireland's Department of Health has awarded Deloitte Ireland LLP a contract to review the national medicines pricing and reimbursement system from initial assessment through to funded patient access. The work moves a review announced by Minister for Health Jennifer Carroll MacNeill TD in June into implementation.
The current pathway contains several successive stages. The Health Service Executive (HSE) receives reimbursement applications and commissions the National Centre for Pharmacoeconomics (NCPE) to undertake rapid review and, where required, full health technology assessment. Commercial negotiations may then follow. More complex applications can proceed to the HSE Drugs Group for a reimbursement recommendation, followed by a decision by HSE leadership and, where required, development of a Managed Access Protocol before treatment reaches patients.
The review will examine this complete sequence. Carroll MacNeill said its purpose is to identify where delays arise, where processes can be streamlined and how decisions can be made more efficiently and transparently while retaining rigorous clinical and value assessment. It will also examine the Rare Disease Technology Review Committee, including whether its role should be formalised and integrated more closely with HTA.
This goes beyond the Mazars governance review published in 2023. That exercise identified improvements in transparency, communication and application tracking and subsequently led to additional staffing and the HSE medicines reimbursement tracker. The new procurement is explicitly classified as business-process management, process improvement and process re-engineering.
It also sits alongside the 2026–2029 Framework Agreement on the Supply and Pricing of Medicines. That agreement sets a progressive objective of reaching a 180-day assessment and reimbursement timeline by the first quarter of 2029, together with defined targets after HTA, Drugs Group consideration and reimbursement decisions, including 90 days for implementing Managed Access Protocols.
The review will therefore test whether Ireland's existing institutional sequence can meet those commitments or whether deeper changes to responsibilities, hand-offs and decision-making are required. Deloitte's contract has an estimated value of €140,000 excluding VAT and a 12-month duration; the Minister previously indicated that the review itself should take six to nine months after award.
Source: Department of Health / eTenders
Link: Provision of Strategic end-to-end review of the Irish medicines Pricing and Reimbursement system for Department of Health PAS122F
Date: 7 August 2026
Source: Dáil Éireann
Link: Rare Diseases: Statements
Date: 18 June 2026
Source: Department of Health
Link: The Framework Agreement on the Supply and Pricing of Medicines 2026–2029
Date: 8 April 2026
