The urge of medicine accessibility

By Sara Cerdas, MEP (S&D, Portugal), Member of the ENVI Committee, European Parliament

As we are building an European Health Union we need to understand what the real needs are and how, as a Union, we can tackle them. As the pandemic struck the Members States in unprecedented waves and unveiled the gaps on preparedness and response to a health crisis, the European Commission has acted to mitigate the effect of the pandemic on all health determinants such as health care, vaccines, medicines, but also economic and social support to the ones who need it most.

European Health Union, a mechanism demanded by the socialists and democrats in the European Parliament, is taking its first steps and we will be more prepared, more coordinated and more resilient to future health crises, starting acting now at a local, national and EU level.

It is essential that the health systems be as sustainable as possible and all resources should be allocated in the best way possible, to ensure that the citizens’ and patients’ needs are met.

The long-time medicines shortages problem was exacerbated and clearly unveiled in the EU and highlighted the need to manage the EU pharmaceutical system.

One of the lessons we learnt from the pandemic is that we must ensure timely access to safe, high quality and affordable medicines at all times to all citizens.

The Pharmaceutical Strategy for Europe, alongside the revision of EMA mandate and other health actions and programs, as EU4Health and the EU Beating Cancer, are an opportunity for the EU to position itself as a champion and to revise the pharmaceutical legislation and work together to achieve true accessibility across the Union.

The momentum is now and it is necessary to increase the health of citizens and for that we must ensure secure, affordable and available medicinal products and medical devices, without deteriorating the other actions that will increase the health status and wellbeing of populations. In other words, we need to fight the battle fronts: promote health and prevention of disease on one hand and invest in better treatments and better quality of life for patients on the other.

For both we must have medicinal products to treat or cure diseases or to use them through their prophylactic effect. This is only possible by investing in research and development of new drugs, vaccines and devices.

The EU had a robust research and innovation investment programme, the Horizon 2020, that today gives place to Horizon Europe, that has supported a multitude of different research projects, with results widely known by the general population. One example is the mRNA vaccines, currently well-known by the population as the COVID-19 vaccines, in which the EU had a substantial role in supporting research projects that use this technique for years to achieve the knowledge level we have nowadays and allow the development of efficient vaccines in record time.

But it is impossible to dissociate the discussion of accessibility of medicinal products and medical devices from the discussion of transparency of net pricing and reimbursement of different treatments.

It urges a balance between investments in pharmaceutical research, to promote the fixation of companies within the EU in global competitiveness, to reduce the environmental footprint and to contribute to reduce the unmet needs of the population. One of the most prominent problems nowadays is the investment made to discover and produce new medicinal products (as medicines or vaccines) and its reflection in the cost of these products. Towards this end, the future European Health Emergency Preparedness and Response Authority (HERA) will play a key-role in enabling rapid availability, access and distribution of needed countermeasures in times of crisis.

As these costs are unaffordable to many of the European countries, the EU joint procurement should be promoted to increase the accessibility and affordability of new medicinal products to all Member States, reduce the competitiveness between countries and improve the negotiation leverage of the EU when purchasing certain medical products.

But we already had other agreements between Member States that are successful case-studies.

The Valleta Declaration and the Benelux initiative are two good examples that allow Member States to have the accessibility to innovative medicines at the same time it contributes to the sustainability of the healthcare systems.

The success of these examples occurs due to strategic cooperation between Member States, with sharing of information, identification of good practices, extended evaluation of innovative medicines and treatments, and negotiation of price through joint procurements.

As we saw during this pandemic, the joint procurement agreement for medical countermeasures in case of cross-border health threats resulted in a united effort of member-states that allowed the EU to benefit from competitive advanced purchase agreements, allowing all citizens to have equality in the access to COVID-19 vaccines. But this mechanism can go beyond a pandemic crisis and should be developed to be a reality at all times, to allow countries to have rapid, fair, equal and affordable access to future vaccines and treatments once they are available.

It is time for the Commission to push forward the discussion of transparency of net pricing and reimbursement of different treatments, increasing the equality between the Member States when in negotiation with pharmaceutical companies.

As an European, I believe that the EU project is a way of achieving an equal, fair and sustainable society, but also a healthier one. Today we are building the future, we are building up a European Health Union and we need to act together to ensure safe and quality healthcare to all, including the access to (innovative) treatments, prophylaxis and medical devices. We can and we won’t leave no one behind.