Ireland’s healthcare system may be sitting on a major cost-saving opportunity. Wider use of biosimilar drugs could help the HSE cut its annual medicines bill by almost €150 million, while still supporting access to critical treatments for patients.
The claim comes as pressure grows on public health budgets and as more high-cost biologic medicines lose patent protection across Europe. For policymakers, procurement teams and health technology observers, the message is clear: the next wave of pharmaceutical savings may come not from cutting care, but from adopting smarter drug alternatives faster.
Why biosimilar drugs matter for the HSE
Biosimilar drugs are lower-cost versions of biological medicines, which are treatments derived from living cells. Unlike standard generic medicines, they cannot be copied exactly because biologics are complex, living products. Instead, biosimilars are highly similar in safety, quality and effectiveness to the original branded medicine.
That distinction matters because biologics are often among the most expensive therapies used in modern healthcare. They are widely prescribed for conditions such as:
- Psoriasis
- Autoimmune diseases
- Bone disorders
- Diabetes and obesity
As more of these branded medicines lose exclusivity, biosimilar drugs create a chance for health systems like the HSE to reduce spending without lowering standards of treatment.
The scale of the potential savings
According to Sandoz, biosimilar competition already generated an estimated €239 million in savings for Ireland’s healthcare system in 2025. But the bigger headline is the unrealised potential: a further €148.8 million in annual savings could be unlocked through stronger uptake of biosimilar drugs already on the Irish market and by introducing more products that are already available elsewhere in Europe.
That figure is significant in any budget environment, but especially at a time when healthcare costs continue to rise. If those savings were achieved, the HSE could potentially redirect funding into staffing, diagnostics, digital infrastructure or expanded patient services.
In technology terms, this is less about a scientific breakthrough and more about system efficiency. The medicines exist. The commercial opportunity exists. The challenge is adoption.
Why Ireland is behind on biosimilar uptake
One of the key issues is market access. Of the 26 biosimilars currently available in Europe, only 11 are being marketed in Ireland. That places Ireland near the bottom of the European league table for uptake.
Several factors appear to be slowing progress:
- Limited product availability: not all approved European biosimilars are reaching the Irish market
- Slow procurement processes: the HSE’s best-value biologics programme can take around 240 days
- Competitive thresholds: tenders are only triggered when at least four competing products, including the originator, are present
- Uneven adoption: some parts of the health service switch to lower-cost medicines faster than others
This combination creates a fragmented system in which cost-saving medicines are available, but not consistently used. In digital transformation language, it is a classic execution gap: policy intent exists, but operational follow-through is patchy.
A case study: ustekinumab
The psoriasis treatment ustekinumab shows how large the gap can be. The drug reportedly has the potential to save the HSE close to €30 million a year, yet uptake in Ireland is said to be around 30 per cent, far below the HSE target of 80 per cent.
That shortfall highlights the central problem with biosimilar drugs in Ireland: savings do not materialise just because alternatives are approved. They only happen when clinicians, hospitals, procurement teams and health administrators all move in step.
The next decade could be a turning point
The outlook for biosimilar drugs is likely to become even more important over the next 10 years. Globally, hundreds of billions of euro worth of branded medicines are expected to lose patent exclusivity by 2036, creating a major opening for biosimilar competition.
That incoming patent cliff could reshape drug spending in several major therapeutic areas. Particularly important markets include:
- Immunology treatments
- Cancer therapies
- Osteoporosis and bone disease medicines
- Diabetes and obesity drugs
The last category may be especially noteworthy. With demand for obesity and diabetes treatments surging worldwide, lower-cost alternatives could become a major strategic tool for national health systems trying to balance access and affordability.
For Ireland, the timing is crucial. If the HSE can modernise its procurement model and accelerate adoption pathways now, it may be better positioned to capture value from the coming wave of biosimilar drugs.
What needs to change
If Ireland wants to close the gap, several practical steps stand out:
- Speed up tender and reimbursement timelines
- Encourage more manufacturers to launch biosimilars in Ireland
- Improve consistency across HSE regions and hospitals
- Track uptake targets more closely and enforce accountability
- Support clinician and patient education around biosimilar safety and effectiveness
These are not just pharmaceutical policy issues. They are health system innovation issues, where better processes, faster decision-making and stronger coordination can unlock savings at scale.
In the end, biosimilar drugs represent one of the clearest examples of how smarter adoption of existing medical technology can produce real financial impact. For the HSE, nearly €150 million in annual savings is not a small efficiency gain; it is a strategic opportunity. If Ireland can remove the barriers holding back biosimilar drugs, it could reduce medicine costs, improve system resilience and free up funds for other urgent healthcare priorities.
