by Edouard Hubert at the Pharmaceutiques’ meeting

MARSEILLE, Dec 15 (APM) - France’s pharma industry and the head of the country’s drugs pricing committee have disagreed over the need to create further means of funding innovation, a conference heard.

Dominique Giorgi, chairman of the French economic committee for health products (CEPS), highlighted a plethora of mechanisms designed to generate savings in healthcare spending.

While Patrick Errard, chairman of the French pharma body (LEEM), said more needed to be done to pay for forthcoming innovative drugs in companies’ pipelines.

The leaders were speaking during a debate entitled: “What will be the cost of the health technology revolution?” at the Pharmaceutiques' journal meeting, in Marseille on Friday.

Next year, CEPS and LEEM will need to re-negotiate the framework agreement that binds them, as the current agreement is due to terminate on December 31, 2015.

Speaking at the conference, Dominique Giorgi said the “sources of savings” on drugs to finance costly new products “(were not) exhausted”.

He underlined that a margin was generated thanks to drug price cuts, the development of generic drugs, and to “economic prescription,” referring to the generic drugs repertoire, and to control of healthcare expenses. He also mentioned the forthcoming arrival of several biosimilars as a means of cutting costs.

Errard, however, said these potential savings were not sufficient in view of the innovations announced and he called for the “opening up of budgetary reflection”.

“We have long asked the pharmaceutical industry to finance itself and it seemed to work out. Now, we can see that with breakthrough innovations, a system with a set budget is not enough,” he added, pointing out that a “drug has an efficiency that intervenes on the whole scope of care”.

“As the care pathway has changed, let us change the structure that supports it,” the LEEM chairman added. In particular, he said the “hospital network decided on after the war is not longer adequate”.

Consequently, he called for “in-depth reform of the care system,” emphasising however that this requires “political courage” and “much time”.

Giorgi agreed with the fact that savings can be captured in other domains, but “you have to be able to do this” he pointed out.

The debate also touched on changes in drug pricing methods, with Giorgi saying they must change. He announced that CEPS had begun a review of the difference between the face value price and the net price (namely, once rebates have been paid to health insurance) of drugs. “We have to think about intelligent net prices, not just net prices as of the first box,” he said.

He also mentioned “a change in the pricing doctrine” in oncology, as an extension of the Cancer Plan. CEPS plans to organise an internal seminar on the subject in January 2015 with a view to making proposals “at fairly short notice”. The chairman of the committee mentioned two problems, drugs that obtain successive indications but that have clinical benefit rankings (ASMR) that can vary, and combinations of costly drugs.

Before the CEPS chairman spoke, the chairman of the French national authority for health (HAS) had made known his “astonishment” about the prices requested by pharma for innovative products.

“The justification (put forward) is very often the cost of R&D. I fully understand that pharmaceutical companies are not philanthropic but I think it is necessary to separate research from development. In the case of R, it is quite understandable there are uncertainties …, but D poses problems (for me) when I see errors or the excessive speediness with which some Phase III studies are organised … It is not right that those costs should be reflected in the price of the next products,” said Jean-Luc Harousseau.

Harousseau, who is also a haematology professor, mentioned the case of a molecule in his field, thalidomide, placed on the market by Celgene with a high price although the pharma company “had carried out no real development. It all came from the clinical research groups”.

“Moreover, what surprises me is the fact that I do not see why innovative drugs should systematically be more expensive than what already exists. In other industries, people also invest in efficiency … I would like the industry to change its approach, to stop saying “efficiency, we are not concerned with that,” he added. He expressed a desire to see accepted for reimbursement only drugs that are more effective and efficient or more efficient.

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