by Peter O'Donnell
BRUSSELS, June 16 (APM) - The issue of high drug prices took centre stage at the European Union health council on June 16 - but with some divergent views about how to move ahead.
The formal conclusions of the meeting invited member states "to cooperate in order to increase transparency in the pricing of pharmaceuticals, which should put the member states in a better position when negotiating with the industry."
The health ministers of the 28 member states agreed to strengthen member state cooperation in overall healthcare, but, as Germany underlined in a strong statement of its reservations, only on a voluntary basis, in full respect of national sovereignty.
Chris Fearne, the Maltese Minister for Health who chaired the meeting, said closer cooperation would be particularly valuable for patients to ensure access to innovative medicines as they become available.
But their "high price tag" remains an obstacle, so "we health ministers should indeed be discussing this", he said.
The meeting agreed on the prospect of better outcomes for patients and healthcare professionals and increased efficiency of health systems from more cooperation.
In particular, the conclusions state that cooperation could help in "access to health technologies arising inter alia from therapeutic innovation, in particular in the field of rare diseases, and the development of personalised medicine."
But Germany made clear that although it agreed with the concept of purely voluntary cooperation, and that it would therefore subscribe to the conclusions, the very strict limits to what the EU treaty permitted in terms of intervention in healthcare would have to be respected.
It is important that the Commission is not involved in voluntary cooperation between member states, insisted the German delegation at the meeting. The manner and scope of cooperation should be determined by member states alone, respecting the differences between them and their situations and choices.
"There is no one-size-fits-all solution", Germany concluded.
Portugal too, explicitly recognised the reserve expressed by Germany, but nevertheless saw great potential in the development of voluntary bilateral or multilateral cooperation among member states, particularly on innovative medicines.
The Portuguese delegation, reflecting on some of the recent informal discussions between member states about the scope for greater cooperation on drug prices, spoke of the "hope that this was the start of something big."
Many member states gave strong support to the conclusions' call for the exploration of "priority areas and appropriate processes for the development of member-state driven voluntary cooperation, as a way of increasing the effectiveness, accessibility and resilience of their health systems."
Ireland enthusiastically supported the conclusions and said it would have preferred "a more ambitious approach", since "the prices that some companies with a monopoly are seeking to charge means products will never reach patients".
"Countries must continue to challenge drug firms and pricing practices", Ireland insisted, suggesting EU membership "offers the opportunity for cooperation to reduce the cost of new medicines."
And the Commission "has an important role to assist members states in creating platforms for mutual cooperation, horizon-scanning and joint negotiations."
Hungary and Lithuania particularly favoured cooperation on transparency of medicines prices, as a contribution to ensuring that medicines would be available all over Europe.
Greece wanted to take cooperation further to establish a framework for wider access to overcome "the injustice of medicines", with a structured dialogue with the pharma industry to guarantee patients' rights to access.
Denmark too urged equal access and the establishment of fair pricing of pharmaceuticals, and Cyprus was very keen to work with other member states on access to innovative medicines.
The Netherlands claimed it had seen "clear benefits" from its cooperation in the 'Beneluxa' experiment with Belgium, Luxembourg, and Austria on joint negotiations with drug firms.
It had allowed "better-informed decisions", even though this requires a major commitment of time and resources.
Health commissioner Vytenis Andriukaitis expressed the Commission's full support for the proposed cooperation, pointing out that voluntary cooperation already takes place in many areas of policy.
To move ahead, the focus should be on "building a trusted conversation" rather than on designing structures and mechanisms, he said.
He hoped that cooperation could lead to collaboration and ultimately to coordination, and said he would be "more than happy to see the next steps".
There was further support for access to healthcare as a right in a related debate among ministers as to how far health should be incorporated into the EU's planned 'European pillar of social rights'.
This initiative proposes a principle of the right for everyone to have timely access to affordable, preventive and curative health care of good quality.
But Germany again expressed reservations, while supporting the principle of upward social convergence.
The sections on healthcare and long-term care need clarification and definition, said the German delegation, rejecting the current wording because it could give rise to misunderstanding.
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