PND11 - European Collaboration for Innovative High Cost Medicines

Abstract

In order to promote availability, affordability, and accessibility of innovative medicines, European countries joined efforts, via cross border collaborations, to increase their negotiating power with pharmaceutical industries. This study aimed to present potential implications of the EU voluntary cross-border collaborations for the assessment of innovative medicines for reimbursement decisions. A literature review was conducted through PUBMED, EMBASE, and grey literature to identify EU voluntary cross-border collaborations and their aims. Four identified collaborations aimed to facilitate access to innovative health technology at affordable prices: “Valletta Declaration” (2017) between Cyprus, Greece, Italy, Malta, Portugal and Spain, Ireland, Romania, Croatia, Slovenia, “Southern European initiative” (2016) between Greece, Bulgaria, Spain, Cyprus, Malta, Italy, Portugal, “Nordic Pharmaceuticals Forum” (2015) between Denmark, Iceland, Norway, Sweden and “BeNeLuxA” (2015) between Belgium, Netherlands, Luxembourg, Austria. The collaborations are based on sharing information on prices, markets, and disease-specific cross-border registries; horizon scanning of new health technologies; joint negotiation/procurement on pricing and reimbursement and to reach common conclusion on to the added therapeutic value of the product. Huge potential gain from this cross-border collaboration is expected, especially on horizon scanning because decision-makers could forecast the impact of innovative health technologies. As a consequence of the joint Health Technology Assessment (HTA) process, Netherlands and Belgium from “BeNeLuxA” rejected the reimbursement of a cystic fibrosis drug, stating that the asking price was 82% more than its perceived value. However, there may be potential limitations for the collaborations, especially in economic evaluation where the costs and utilities may vary between countries. HTA and procurement collaboration between EU countries is emerging as a response to the perceived gap between drug price and value. Increase purchase power may change the current negotiation power. It will also certainly influence the future joint HTA initiative of the EU Commission .