Drug-makers ‘welcome’ EU talks on prices

Industry lobby confident of greater co-operation.

The new head of Europe’s powerful pharmaceutical industry lobby has plunged straight into a decades-old debate about how much Europeans should be paying for medicines. 

Despite the difficult economic conditions, Richard Bergström, director-general of the European Federation of Pharmaceutical Industries and Associations (EFPIA), is optimistic about winning better treatment from national healthcare authorities for products made by the association’s members.

“I see for the first time that the payers are starting to discuss not just what sort of innovation they want, but what they are ready to pay for,” Bergström, who took up the post in April, told European Voice.

This change in thinking can also be seen within the industry, which is participating in a series of working groups set up by the European Commission, even on hitherto taboo subjects such as priorities in medicine development. “Back in 2004, industry was very nervous about any discussion with the authorities on what we develop, but now we welcome it,” said Bergström.

The change springs from tougher circumstances. On Monday (6 June), health ministers from EU member states noted, after discussing investing in health, that the challenges posed by growing costs in “the current uncertain and fragile economic climate” are “progressively limiting the resources available to member states’ health systems”. The limitations are reflected in the price cuts and budget freezes that most countries in Europe have been imposing on drug spending.

One of Bergström’s priorities is to develop more constructive dialogue with national authorities. “We want to get in early with governments – not to claim immunity from their efforts to make savings, but to discuss with them how things can be done in an intelligent manner that will save money without destroying long-term innovation.” So far, progress has been made with Denmark, Ireland, the Netherlands, Portugal, Spain and Sweden, he said.

But he also sees a need for greater engagement at EU level. “The market uptake of innovation is slowing down, and if the Commission really wants to do something, this is where it should act,” he said.

Assessments

EFPIA has made a priority of defining an effective approach to health technology assessment (HTA), an often-controversial method employed by national authorities to reach pricing and reimbursement decisions. EFPIA claims that HTA requirements vary from country to country, and that there is a “lack of alignment among HTAs, and between HTAs and regulators, about what value is and, more specifically, how it can be appropriately assessed”.

Bergström sees a role here for the Commission. “It can foster greater clarity over the use of HTA, and bring greater coherence to the current disparate patchwork of national systems.”

The EFPIA boss sees significance in a meeting that took place in Budapest in May between industry and the EU’s network of national officials responsible for drug pricing. “That was the first time we had been invited to meet them,” he said. In contrast to industry’s frequent meetings with regulators responsible for the safety or efficacy of medicines, “this was new, with pricing ”.

Bergström said that this nascent co-operation might slow or even stop the downward spiral resulting from the tendency of pricing authorities to base their decisions on the lowest prices charged in other countries, and agreed principles for pricing decisions.

Closer co-operation could also lead to schemes for managing the market entry of medicines, increasing the speed of patients’ access to innovations without putting at risk the equilibrium of national drug budgets, and shifting the debate away from unit prices and sales volume to effective usage. “We are now discussing with the Commission subjects such as incentives and proper use of medicines…I’m optimistic,” he said.

Success will depend on building greater trust, Bergström said – between the industry and regulators, and among regulators from across the EU. He will have his first major public opportunity to build trust at EFPIA’s annual conference in Brussels next week (14-15 June). The meeting will focus on industry’s contribution to two of the issues highlighted by this week’s discussion between health ministers: the Europe 2020 European Innovation Partnership on active and healthy ageing, and what the Council called “one of the major challenges to health systems… the growing rise of chronic diseases”.

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