INCREASING EQUITY IN EUROPEAN HEALTHCARE

Policy-makers and the pharmaceutical industry across the EU

share the goal that all citizens and patients in Europe should enjoy
equal access to the right medicines and vaccines - valuable
innovation can transform lives. If policy makers, the
pharmaceutical industry, health insurers, patients and others work
together to achieve that goal, the result will be healthier citizens,
enhanced competitiveness, more balanced budgets, and fair
reward for innovation.
John Dalli, European
The need for greater equality is clear. In cancer, incidence in the Commissioner for Health
EU is increasing, but mortality is decreasing, thanks to earlier and Consumer Policy 
diagnosis and new treatments. However, there is significant
variability in patient access and in relative survival rates. Similarly,
we see wide variability between Member States in the speed with
which valuable innovative medicines become available to
patients, and then further variability in uptake between Member
States and between disease areas.

But the challenge of delivering equality across Europe is equally Andrew Witty, CEO of
clear. Health services everywhere face enormous challenges. GlaxoSmithKline and
Governments are understandably struggling to cope with rapid President of EFPIA 
demographic change, the pace of technological change, and
unbridled demand for healthcare. The current financial crisis exacerbates the difficulty of
balancing desire for healthcare equality with the need for financial management.

Against this background, Governments need to maximise public health outcome for a given
budget, and to make choices. They are focussing on value for money, and rely increasingly on
processes like health technology assessment (HTA) for decision-making. This is appropriate. But
HTA requirements in different Member States vary considerably, which causes complexity for
industry. The ongoing fragmentation of healthcare delivery in Europe introduces further
challenges.

In this challenging climate, it is vital to achieve the best results for patients across the European
Union, for public budgets and for industry. This requires an equilibrium between the needs of
different players, with patients put first. All stakeholders need to change the way they think and
act, with ‘health for all’ achieved collaboratively at local, national and European level. ’All for
health’ should be the key enabler - the more institutions work in a trusting environment, the more
likely the right approaches can be developed.
Industry must be a genuine partner to governments and their agencies. It must deliver new
medicines and vaccines that address unmet patient need and have demonstrable value. This
means getting R&D right – reversing the decline in productivity and delivering medicines that
match the health needs of the population. Industry must increase the transparency of what it
does and be a source of ideas to governments, including on increasing funding and more
efficient use of budgets. The pharmaceutical industry is hugely innovative. If governments work to
support innovation, the industry will deliver the next era of revolutionary medicine.

Governments have the key responsibility for delivering equitable healthcare. It is possible for them
to encourage and reward therapeutic progress, while maintaining core characteristics like equity,
public funding and strict regulation.

We must create in Europe the right policy and regulatory framework. This requires that effective
prevention and wellness programmes are in place. We must shift focus from cost to value, and
set a strategic agenda that addresses unmet needs. This will allow industry to understand the type
of added value that matters to patients and will be funded by payers. Gaining a shared
understanding of value depends on high quality dialogue between industry and authorities.

HTA plays an important role. We need a degree of flexibility to ensure that the government does
not pay for medicines that do not work but that equally, patients get access to medicines that
may help them.

There is a clear case for closer cooperation on HTA within the Union. A single approach in the EU is
undesirable, since Member States will want to make decisions according to their own priorities. But
the current diversity and overlap leads to unequal access for patients, complexity for industry,
duplication of work, and unnecessary red tape. While the final decision has to remain national, in
particular on price and reimbursement, we should explore a common HTA methodology on the
clinical aspects of health technologies in Europe which might then be used for assessments of
relative efficacy and effectiveness at European level.

Ultimately, this is about improving the lives of citizens and patients – putting patients at the heart
of decision-making. They should be empowered to make informed choices about access,
allocation of funding and assessments of value.

Greater equality in healthcare will lead to healthier citizens, but also to more competitive
economies, and efficiently-managed healthcare budgets. All stakeholders must work, in
partnership, towards that goal. The European Commission is striving to create the right framework,
in particular through its public health and innovation policy. Now the pharmaceutical industry,
Member States and others must respond.

John Dalli, Andrew Witty,

European Commissioner for CEO of GlaxoSmithKline

Health and Consumer Policy and President of EFPIA