by Peter O'Donnell
BRUSSELS, Dec 2 (APM) - Europe's health ministers returned to the subject of drug prices at their council meeting in Brussels, but the conclusions agreed do not record much progress.
The debate followed the informal council meeting in Milan in September, which focused on the joint challenges of affordable prices and support for innovation. (
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The conclusions from Monday's meeting recognise the need to see scientific advances translated into innovative medicines, and the problems that research faces. The development of innovative medicinal products is costly and risky and investment may not be enough without more incentives or changes in the environment, they say.
But at the same time, the text the ministers signed off, is full of warnings and precautions and conditions. New medicines merit support if they have added value for patients and at prices that member states’ health systems can afford, said ministers.
The conclusions expose the anxieties that many member states have expressed this year at the cost of Gilead's Sovaldi for hepatitis C and some new cancer treatments, anxieties that led France and Italy to spearhead attempts at a common EU front in negotiations with drug firms.
Earlier versions of the draft conclusions reflected those anxieties very clearly, but the final version agreed by ministers, after weeks of discussions among officials, under pressure from larger member states such as Germany and the UK for a more neutral text, waters down the language.
"Due to the very high prices of some innovative medicinal products in relation to their benefit to patients and to the public health expenditure capacities of some member states, patients do not always have access to innovative treatments”, ministers said at their council meeting on Monday.
But they do invite the member states to explore how they might share more information on prices and expenditure relating to medicines, with special reference to innovative medicines.
Italy's health minister Beatrice Lorenzin, who chaired the meeting, put a brave face on the outcome afterwards. "There has been movement towards a common approach," she told APM.
Drug industry executives told APM they see the compromise as the inevitable outcome of deeply different national approaches. While many smaller member states would like to co-operate more in mounting a common front to negotiate harder with drug firms over pricing, Germany and the UK resist such moves.
"This isn't because big member states don't care about high prices," one senior industry figure told APM on condition of anonymity. "But the UK and Germany are big enough to be able to conduct tough negotiations themselves with drug firms, so they have nothing to gain and much to lose from working as a team with other member states".
EFPIA issued a non-commital statement after the meeting, simply noting that it is "important to listen to perspectives in the on-going discussion."
Germany and the UK were also both conspicuous at the health council for defending their sovereignty in health matters. They took a firm stand against deeper EU co-operation on health-oriented input to broader EU discussions of economics and competitiveness.
Italy, as current president of the health council, asked member states for their views on how health policy should be factored into the EU's medium-term growth strategy action, known as Europe 2020 and into the annual European semester exercise on national budgeting.
While many national health ministers welcomed the concept during the discussion in the council, Annette Widmann-Mauz, parliamentary state secretary to Germany's federal minister of health said: “We reject any process that would lead to unification of systems in Europe.” She added: "There should be no undermining of member states’ competence.”
For the UK, ambassador Shan Morgan, deputy head of the UK's permanent representation to the EU, also warned against broadening the EU engagement with health, or mixing it with economic concerns.
“Europe 2020 should remain firmly on jobs and inclusive growth. The EU can improve health outcomes through legislation on tobacco, medical devices and a new EU alcohol strategy,” she said.
The Italian presidency had better luck with conclusions on vaccination - ministers agreed there should be more research, wider use, and better training of health workers.
In the margins of the council, Denmark and Lithuania signed up to the EU's voluntary joint procurement agreement which was introduced to ease countries' access to pandemic vaccines in times of emergency. This brings to 20 the number of member states that are signatories.
On patient safety too, ministers agreed that more should be done to combat overuse of antibiotics and to reduce iatrogenic disease, particularly in hospital-acquired infections.
But the council was ready to do no more than to simply take note of a presidency progress report on the draft legislation on medical devices and in-vitro diagnostics.
A dozen member states had already indicated they were unhappy with the compromises worked out over the last two years of discussion. They said before the meeting that they would not endorse a compromise text that could have permitted the final stage of talks with the European Parliament to begin.
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