Ireland’s Axis Reimbursement starts US push as revenue heads towards €5m

Axis Reimbursement, a Dublin-based healthcare consultancy founded by former nurse Brenda Dooley, has begun expanding into the United States as it forecasts annual revenue of €5 million in 2026. The move takes a business built around Irish and UK medicines reimbursement into a new phase of international development.

The company started its US push in June, Dooley told the Business Post, with Enterprise Ireland providing access to its offices and support on the ground. Axis already has offices in Dublin, Galway and Manchester, and employs 20 permanent staff alongside 10 contractors.

Its revenue forecast compares with €3.3 million in 2025, implying growth of approximately 52% if achieved. The report does not identify a US city, a dedicated American office or a local hiring plan, and does not break out any revenue attributable to the US initiative.

Selling the evidence behind reimbursement

Axis works with pharmaceutical and biopharmaceutical companies to demonstrate that new medicines offer value for money. Its work involves assembling evidence of clinical effectiveness and cost-effectiveness to support applications for reimbursement through public healthcare systems, including Ireland’s HSE and the UK’s NHS.

“We help patients get access to new innovative medicines by supporting pharmaceutical and biopharmaceutical companies in demonstrating value for money. That’s a state requirement before they get reimbursed,” Dooley told the Business Post.

That expertise provides the strategic context for the US move. Dooley is presenting Ireland as a gateway to Europe when speaking with pharmaceutical companies internationally. The opportunity she describes is therefore not simply a new geography for Axis: it is a chance to bring its existing reimbursement knowledge to companies considering European market access.

“When I focus on internationalisation and speak with pharmaceutical companies, I ask them to think about that and how we can facilitate that pathway,” she said. The report does not establish whether Axis also plans to advise on US domestic reimbursement.

An Irish base, followed by the UK

Dooley founded Axis in 2011 after working first as a nurse and then in the pharmaceutical industry, including as Pfizer’s head of market access. She identified an opening as reimbursement decision-making in Ireland became more formalised, following a pattern she had observed in the UK.

“The real problem was that there weren’t many providers of in-country expertise that would inform those submissions,” she said. That focus on country-specific knowledge remains central to the business’s origins and its pitch to international pharmaceutical companies.

Axis began as a one-person operation and remained a small team until 2018, when it started building more substantially. Dooley said the shift to hybrid and online working during the pandemic helped the consultancy reach more international audiences.

The business expanded into the UK about three years before the October 2026 interview. Dooley said it had since secured 6% market share there, although the report does not define the market used for that figure. She also described Axis as having built a leading position in Ireland.

Early-stage US market development

Enterprise Ireland has supported Axis at overseas trade shows as well as during its initial US activity. For now, the reported American move is an early-stage market-development effort rather than a detailed office rollout. Its commercial test will be whether the company can translate its Irish and UK expertise into new international client relationships.

The Business Post interview was published as part of its Making it Work series, produced in partnership with Enterprise Ireland.