I propose to take Questions Nos. 335, 342, 345, 363, 367, 377, 379, 381 to 384, inclusive, 387, 400, 402, 404, 415, 422, 427, 431, 433 and 439 together.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Health Act and the national framework agreed with industry, if a company would like a medicine to be reimbursed by the HSE, the company must submit an application to the HSE to have the new medicine added to the reimbursement list. Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria, including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
I am advised by the HSE that, in April 2020, the NCPE received a reimbursement application dossier for Onasemnogene abeparvovec (Zolgensma). On 13 May 2020, the NCPE completed a rapid review with respect to this application and recommended a full Health Technology Assessment (HTA) to assess the clinical effectiveness and cost effectiveness of Zolgensma compared with the current standard of care.
The HTA was undertaken as a part of the Beneluxa collaboration between Ireland, the Netherlands and Belgium, with Austria acting as a reviewer in the Belgian procedure.
The HTA was completed in May 2021 and an assessment summary is available on the NCPE's website. At the conclusion of this HTA, the NCPE recommended that Zolgensma not be considered for reimbursement unless cost effectiveness could be improved relative to existing treatments. Pricing/reimbursement negotiations have commenced July 2021.
A final decision on the pricing/reimbursement application for Zolgensma will be made in accordance with the 2013 Health Act.
Questions relating to specific individual patients are an operational issue and are therefore a matter for the HSE. Section 6 of the HSE Governance Act 2013 bars me as Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.