The recent decision by two health insurers to make innovative cancer treatments available more quickly to their customers is welcome. Irish Life Health and Laya Healthcare say they will make these life-preserving treatments available to subscribers once the drugs have been clinically approved by the European Medicines Agency.
Their decision, taken after the issue was highlighted in this newspaper, will end the disparity in cover between these companies and their rival, VHI. The State-owned insurer has been funding these treatments since 2019. Over time, more immunotherapies have become available, treating a wider variety of cancers, thereby increasing the disparity in cover.
The decision should reduce the time seriously ill patients have to wait for access to drugs by up to two years. Up to now the two companies waited until the HSE made a decision on reimbursing the treatments for public patients before giving the go-ahead to fund their own customers. The State’s drug approval process is a lengthy one in which the National Centre for Pharmacoeconomics first decides on the cost-effectiveness of a drug and the HSE then enters into price negotiations with the manufacturer. This stage takes place in secret, and is often protracted. Ireland is the second slowest country in western Europe for funding new drugs, a recent study found.
The State has limited resources for funding new drugs and a duty to allocate these funds fairly for the widest patient benefit. That may mean resisting excessive price demands by drug manufacturers. Yet the extent of the delays in the process suggests a wider lack of urgency about ensuring public patients can avail of the best medicines.
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The U-turn by Laya and Irish Life has eliminated a disparity between customers of different private health insurers but the wide disparity between public and private patients in our two-tier health system remains. That the move was prompted by media attention raises questions about the level of regulation of the health insurance market.