Promote more joint European procurement of medicines

By Kateřina Konecná, MEP (GUE/NGL Group – Czechia), Member of SANT Committee and COVI special Committee

At the beginning, I would like to state that I am a big supporter of the idea of joint procurement of medicines at the EU level. Especially of orphans, drugs against cancer and advanced therapy medicinal products. I supported this idea years before the COVID-19 pandemic, when it was, just a fantasy of a party of weirdos dealing with public health policies in the European Parliament. Subsequently, during the pandemic, the Commission, which never wanted joint purchase of medicines, rediscovered them and introduced them as a tool to purchase vaccines and treatments against COVID-19 for all member states. What was a for decades figment of the imagination of a few dreamers has become a reality in matter of few weeks. We hoped that it would not stop there and that after the end of the pandemic this solution would also be applied to other groups of medicines under the Pharmaceutical Strategy Package. Unfortunately, that didn’t happen.

We have to admit that the potential of the EU joint procurement agreement reaches beyond vaccines and treatments for communicable cross-border health threats. I personally have a number of fundamental doubts and complaints about how the joint procurements of vaccines were implemented during the pandemic.

After all, much has already been written about the lack of even fundamental transparency in both the negotiation process and the signed contracts with pharmaceutical companies. The scandalous treatment of patents developed with the money of EU’s taxpayers or the non-liability of pharmaceutical companies for the resulting product are only the tip of the entire disgusting iceberg of the desperation of the European Commission’s policy in times of a pandemic.

Even the most ideologically hardened supporter of the big pharma must admit after the pandemic that the information and power asymmetry between the multinational pharmaceutical industry as the vendor and national governments as buyers contributes to unsustainable drug budgets and difficulties with thoroughly assessing the proven clinical benefit of new drugs. We have to create a sufficient counterbalance to big pharma and increase our negotiating power. The pharmaceutical industry on the other hand hopes that cross-border purchases of medicines remain a limited possibility because they apply divide and conquer tactics.

If we put aside the purchases of vaccines during the COVID-19 pandemic, then during the last 15 years, we have seen different types of very successful cross-country collaboration initiatives. Such as BeNeLuxA, the International Horizon Scanning Initiative, the FINOSE Collaboration or the most recently the Nordic Pharmaceutical Forum (NPF) initiative). These cross-country collaborations have shown that pooling resources can facilitate access to new medicines for patients at a fairer price. And yes, I do not support this tool for common medicines such as antibiotics or analgesics, which are often missing from the EU market today (EU medicines shortages crises), because from many reasons it is completely inappropriate for the purchase of these drugs.

So, why do I support joint procurement of orphans, drugs against cancer or advanced therapy medicinal products? Due to the indisputable fact that it will help with their availability, price and it will ease the burden on our public health insurance systems and increase their sustainability across the EU.

As the EP stated already in 2017 in its resolution on the access to medicine on which I was the shadow rapporteur, high prices are a major barrier to accessing medicines for patients and a threat to health systems, even in some of the richest countries in the EU.

Joint procurements of the of orphans, drugs against cancer or advanced therapy medicinal products can strengthen bargaining power and aim for fairer prices through joint negotiations, Will ensure the sustainability of healthcare systems. Last but not least they should enhance the understanding and transparency behind the price of medicines and cross-border learning through more information, experience sharing, and horizon scanning. Finally, I also believe that the introduction of these purchases for some drug groups would be positive for pharmaceutical companies as well. They can find opportunities to increase sales revenue by accessing countries that were previously out of reach due to unfavorable market conditions. In addition, they may benefit from increased forecast availability, standardization of supply, and economies of scale.

Unfortunately, big pharma won in the first round, as the Commission presented a proposal for the Pharmaceutical Strategy Package without these joint procurements of medicines. It did not even propose a stable framework for the purchase of drugs against rare diseases. Which is absolute nonsense economically and socially.

The small EU member states should realize during the negotiations that joint procurements of at least these drugs are to their advantage because they do not have market which would be lucrative for a big pharma. I hope that they will help us in the upcoming negotiations.

Yes, the Germans and the French will always secure orphan drugs for their patients at a reasonable price. But what about states where there are only a few units of patients in need of a highly innovative and expensive drug? Me and my colleagues in the EP are determined to bring this back into the game. We’ll see how successful we are. However, we must at least try. After all, we owe it to our patients.