How Ireland Decides Who Gets Liraglutide for Weight Loss — And Saves Millions Doing It
Ireland's managed access system for liraglutide approved about half of physician requests, targeting patients most likely to benefit cost-effectively and saving an estimated €2.4 million in the first year.
Quick Facts
What This Study Found
Ireland's Managed Access Protocol (MAP) for liraglutide (Saxenda) approved 52.2% of the 7,927 physician applications submitted in its first year. By targeting reimbursement to the patient subpopulation most likely to benefit cost-effectively, the MAP contained spending to approximately €3.1 million in 2023 — compared to an estimated €5.5 million if all applications had been approved.
Approved patients differed from denied patients in key characteristics including age, HbA1c, and BMI, suggesting the MAP successfully selected a higher-risk subgroup where the drug offers the most value.
Key Numbers
7,927 applications · 52.2% approved · €3.1M actual spend · €5.5M projected without MAP · Year 1 data · Saxenda (liraglutide 3.0 mg)
How They Did This
Retrospective observational study analyzing two data sources: Ireland's national anonymized MAP database of liraglutide applications and the national reimbursed pharmacy claims database. Compared characteristics of approved vs. denied applications and actual vs. projected expenditure in the first year of the MAP.
Why This Research Matters
GLP-1 drugs for weight loss are expensive, and healthcare systems worldwide are struggling with how to pay for them. Ireland's MAP offers a real-world model for balancing patient access with fiscal sustainability — approving the drug for roughly half of applicants based on cost-effectiveness criteria rather than blanket coverage or blanket denial.
The Bigger Picture
As GLP-1 drugs become the dominant obesity treatment worldwide, healthcare systems face a common dilemma: the drugs work, but covering everyone who qualifies could bankrupt budgets. Ireland's MAP model demonstrates one approach to this problem — using health technology assessment to target coverage. Similar access frameworks are being debated or implemented across Europe, Australia, and other single-payer systems.
What This Study Doesn't Tell Us
Retrospective and observational design. Single-country study specific to Ireland's healthcare system, which may not generalize to other reimbursement models. Only captures the first year of the MAP. Does not directly measure clinical outcomes of patients who received vs. were denied liraglutide. Cost-effectiveness assessments rely on modeled rather than observed outcomes.
Questions This Raises
- ?Do patients denied access under the MAP have worse health outcomes than those approved?
- ?Will newer, potentially more cost-effective GLP-1 drugs like semaglutide change the MAP's cost-effectiveness calculus?
- ?Could similar managed access models work in countries with insurance-based rather than single-payer healthcare systems?
Trust & Context
- Key Stat:
- 52.2% of 7,927 applications approved Ireland's managed access protocol for liraglutide used cost-effectiveness criteria to approve about half of physician requests, saving an estimated €2.4 million in the first year while maintaining access for patients most likely to benefit.
- Evidence Grade:
- This is a retrospective observational study using national administrative data. While it provides valuable real-world evidence on healthcare policy implementation, it does not measure clinical outcomes and is limited to one country's healthcare system.
- Study Age:
- Published in 2025 using 2023 expenditure data. Highly current and relevant to ongoing global debates about GLP-1 drug coverage and affordability.
- Original Title:
- A Managed Access Protocol for Liraglutide for Weight Management: A Retrospective, Observational Study in Ireland.
- Published In:
- Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 28(6), 844-851 (2025)
- Authors:
- Barrett, Rosealeen, Smith, Amelia(2), Gorry, Claire(2), Doran, Stephen, Barry, Michael, McCullagh, Laura
- Database ID:
- RPEP-10102
Evidence Hierarchy
Frequently Asked Questions
How does Ireland decide who gets liraglutide covered for weight loss?
Ireland uses a Managed Access Protocol (MAP) where doctors submit individual applications that are evaluated against cost-effectiveness criteria from health technology assessment. About 52% of applications were approved in the first year, with approval based on patient characteristics like BMI and blood sugar levels that predict who will benefit most.
Why don't healthcare systems cover GLP-1 weight loss drugs for everyone?
The drugs are expensive — Ireland would have spent €5.5 million instead of €3.1 million if all applications were approved. Healthcare systems with limited budgets must target coverage to patients where the investment provides the best health outcomes per euro or dollar spent.
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Cite This Study
https://rethinkpeptides.com/research/RPEP-10102APA
Barrett, Rosealeen; Smith, Amelia; Gorry, Claire; Doran, Stephen; Barry, Michael; McCullagh, Laura. (2025). A Managed Access Protocol for Liraglutide for Weight Management: A Retrospective, Observational Study in Ireland.. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 28(6), 844-851. https://doi.org/10.1016/j.jval.2025.03.017
MLA
Barrett, Rosealeen, et al. "A Managed Access Protocol for Liraglutide for Weight Management: A Retrospective, Observational Study in Ireland.." Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2025. https://doi.org/10.1016/j.jval.2025.03.017
RethinkPeptides
RethinkPeptides Research Database. "A Managed Access Protocol for Liraglutide for Weight Managem..." RPEP-10102. Retrieved from https://rethinkpeptides.com/research/barrett-2025-a-managed-access-protocol
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.