I propose to take Questions Nos. 195 and 197 together.
A standard process is in place for the HSE reimbursement of new drugs, and new indications for existing drugs. This assessment process is intended to arrive at decisions on the funding of drugs that are clinically appropriate, fair, consistent and sustainable. All cancer drugs which have been approved for reimbursement since 2012 have gone through this process.
Nivolumab (Opdivo) is approved by the HSE for reimbursement through the Oncology Drugs Management System for the following melanoma indications;
- As monotherapy for the treatment of advanced (unresectable or metastatic) melanoma in adults.
- In combination with ipilimumab is indicated for the treatment of advanced (unresectable or metastatic) melanoma in adults.
The HSE is considering an application received for reimbursement of Nivolumab (Opdivo) for the following indication (stage 3 Melanoma Cancer patients):
- As monotherapy for the adjuvant treatment of adults with melanoma with involvement of lymph nodes or metastatic disease who have undergone complete resection.
Meanwhile, I am not in a position to comment on the business decisions of a private health insurer on the medicines covered under their schemes.