Attitudes, perceived impacts and motivational factors for European member state collaboration for pricing and reimbursement of medicines : a review of the evidence

Abstract

Initiatives for European Member State collaboration in the area of pricing and reimbursement of medicines started in recent years. In view of the perceived benefits from collaboration and the challenges being experienced with current initiatives, it was necessary to study the attitudes, perceived impacts and the motivational factors concerned. The researcher is a practitioner in this area. The methodology for evidence–based management set by Barends and Rousseau (2018), was found to be systematic, enabled balance of the evidence, filled gaps and addressed biases. Voluntary co-operation was generally favoured for all activities of pricing and reimbursement except for relative effectiveness assessment (REA), where Member State authorities had divergent attitudes while industry adamantly favoured mandatory cooperation. While Member State authorities prioritised impacts related to sustainability of healthcare systems and access to medicines, industry supported economic impacts. Member States’ motivation for collaboration was highly dependent on purpose, political will, implementation climate and cultural factors. The findings of the study were applied to the two decisions already taken. The Proposal for a Regulation on HTA was based on evidence which did not reflect the evidence obtained from this study. The vote at Council is still to be taken. Hopefully Member States realise the risks from this legislation. Regional collaborations are encountering difficulties and need to take bold steps such as transparency of prices and forcing industry participation in joint negotiation. The evidence can be used for future decisions on collaboration. This case study can inform the use of evidence-based management methodology for health policy and regulation.