Our focus extends across both temporal and budgetary dimensions, recognizing the significance of identifying and acknowledging cost offsets that play a pivotal role in addressing the affordability puzzle.
With the European population ageing rapidly, health care budgets are under sustained, significant pressure. This pressure is only amplified by a worsening macroeconomic climate. As a result of this pressure, health care payers across the continent are increasingly reporting that even if an intervention is cost-effective, it may not be affordable within existing budget constraints.
Affordability can by definition only be improved either by reducing costs or improving the ability to pay. However, options related to both of these options appear to be extremely limited in the European context.
This report offers a new perspective on pharmaceutical spending. While it is primarily an investment in better health outcomes for patients, pharmaceutical expenditures can also create efficiencies and cost offsets – net savings – over time and across budgets. The key challenge is for all stakeholders involved to take this broader perspective of time and budget into consideration.
We can no longer guarantee that health care will be accessible to all at all times
Chairman of the board of CZ (third largest health care insurer in The Netherlands), November 2022
Only by taking a broader perspective of time will sufficient resources be dedicated to investments in health care that pay off over time. And only by taking a broader perspective on budgets will we be able to solve the ‘wrong pocket’ problem where the primary payer does not receive the primary reward.
In practice, this can be realised with the existing funding through:
- Long-term horizon scanning of net pharmaceutical costs and multi-year budgeting
- Including the societal value perspective in Health Technology Assessment (HTA)
- Innovative reimbursement agreements for pharmaceuticals
- Integrated (pharmaceutical) budgeting
A further avenue to explore is whether new sources of funding can be found to tap into. Social Impact Bonds for identified health care priorities are one such new funding source showing promising results. Please contact Casper Paardekooper or Willem Wijn to connect on this topic.
ACKNOWLEDGEMENTS
We would like to thank the following individuals for their valuable input during interviews and/or round table discussions:
• Adrian Pana (Center for Health Outcomes and Evaluation)
• Giovanni Gorgoni (EUREGHA)
• Jaime Espin (Escuela Andaluza de Salud Pública)
• Jacqueline Bowman-Busato (European Association for the Study of Obesity)
• Marcin Czech (Institute of Mother and Child, Warsaw, Poland and Polish Pharmacoeconomic Society)
• Matt Hickey (Value Health Alliance)
• Ruben Koekoek (Social Finance NL)
• Thorsten Wolf (Pronova BKK)
European Health Forum in Gastein
Casper Paardekooper from Vintura was asked to kick off the EFPIA – panel during the European Health Forum Gastein this year on the affordability of innovative pharmaceuticals. We discussed the importance of broadening the perspective on affordability and acknowledge the value pharmaceuticals over time and across silos. Pharmaceuticals as an investment in health!
Thanks for a great panel of stakeholders involved in this complex ecosystem. Moderated by Sue Saville and participated by Anca Toma, Jaime Espin, Boris Azaïs and César Hernandez Garcia. And thanks to Sophie Millar, Thomas Allvin and Giulia Presbitero for organizing.
You can also watch the recording of the EFPIA event at Gastein 2023 to discuss whether medicines are affordable for health systems.
