Bad Hofgastein, Austria – Malta is working with Italy and 8 other European countries to lay the groundwork for a formal European Union framework in which members could voluntarily share information about medicines prices, in order to advance more coherent pricing policies in regional markets, Malta’s Deputy Prime Minister and Health Minister said on Wednesday.

The 10 countries of the so-called “Valletta Group” are among the first worldwide to band together on practical steps to implement the aims of the landmark World Health Assembly resolution approved in May, calling for greater price transparency in medicines markets.

Christopher Fearne, Malta’s Deputy Prime Minister and Health Minister, said he expects Croatia, another member of the Valletta Group, to put the issue on the agenda of the European Employment, Social Policy, Health and Consumer Affairs Council [EPSCO] sometime next year, after it assumes the EU presidency.

Fearne spoke to Health Policy Watch following Wednesday’s opening session of the 2019 European Health Forum – Gastein, where he delivered a keynote address at this year’s opening session. Under the banner “a healthy dose of disruption” the Forum is focusing on new policies, digital technologies, research and advocacy, which have the potential to positively transform health systems.

“What we would like to do is to bring this on the agenda of the European Health Council [EPSCO] next year,” Fearne said.

The Valletta Group process is being followed closely both by countries outside of Europe as well as by civil society advocates, to see if the group can formulate a model for practical implementation of the ambitious WHA resolution that others could follow.

Fearne said that the first step for the Valletta group would likely be an agreement to confidentially share information on the prices that they pay for medicines and other health products, so as to begin building trust towards collective negotiations on regional prices for bulk purchases.

Malta hosted a ministerial meeting of the Valletta Group in July, which mandated a group of technical experts to come back to the ministers with a firm proposal for moving ahead on a collaborative framework for price information-sharing, which could also be advanced before the European Health Council.

The group is named after a 2017 Valletta Declaration, in which the countries first agreed to work together to leverage reduced drug prices from industry.  Representing some 160 million citizens, the group of ten countries also includes Ireland, Portugal, Spain, Cyprus, Greece, Slovenia, and Romania, along with Malta, Croatia and Italy.

Italy, the lead sponsor of the WHA resolution, recently enacted its own national legislation stipulating that prices must be disclosed for any new bulk purchases of medicine made.

But Fearne stressed that a European legal framework is needed to empower countries to buck the non-disclosure agreements that are the standard of practice now, and which critics say have led to large disparities in prices paid for the same drug in neighbouring European countries.

“One country is paying 15 000 Euros and another country can’t pay 100 000 Euros. Why can’t we all buy it at 15 000?  The company is still making money,” he said, adding that he was referring to a specific drug that Malta procures, but he could not cite the name due to the NDAs that are currently in place.

“The pharmaceutical companies, when they enter into agreements for procuring medicine, specifically state that you are not at liberty to publicize the price,” he added.

“They usually release the medicines first in countries where there is a high GDP, and so when they [publicly] reference the price, they are referencing the high end of the European market.”

The Valletta Group ministers are due to meet soon again in Rome, to consider the proposals of the technical group, and see if they can form a unified position to submit to the Health Council [EPSCO].

Fearne said that in his opinion, “the next step is to agree between us to share prices between us confidentially, not publicly.  That will enable us to start trusting each other, when we come together to negotiate jointly. So in our case, instead of having a market of half a million, the Valletta Group is made up of 163 million; if we negotiate collectively then we have a stronger bargaining power.

”But because we have always been told that we get the best prices, amongst us there are people who don’t believe that negotiating jointly is going to be beneficial. The only way to break this is to make prices known, and then we will realize the inevitable truth that most of us are paying very high prices.  Breaking this secrecy will allow member states to build trust and then will be able to negotiate jointly.”

Tobacco Control Research Group Receives European Health Leadership Award

In other events at the Gastein Forum, the Tobacco Control Research Group (TCRG) of the University of Bath, United Kingdom, was awarded a first-ever €10,000 European Health Leadership Award (EHLA).

This was the first year for the prize, sponsored by the Austrian Federal Ministry of Labour, Social Affairs, Health and Consumer Protection. A press release said the award was launched to “shine the spotlight on disruptive thinkers who are leading efforts to improve health outcomes across the EU.

TCRG, founded in 2007, was awarded the prize due to its global leadership in tobacco control research that leads to policy action, the Gastein Forum’s organizers said in a press release. The group’s Tobacco Tactics data base has exposed controversial tactics of the tobacco industry, including industry-supported tobacco smuggling to avoid taxes levied on the health-harmful product. The smuggling practices were the focus of two studies published in the BMJ journal, Tobacco Control, over the past year.

Bloomberg Philanthropies has made the Tobacco Control Research Group one of the leaders of an all-new $20 million global tobacco industry watchdog which aims to counter the negative influences of the tobacco industry on public health. The global partnership aims in particular to highlight tobacco industry activity across low- and middle-income countries.

“Tobacco use is one of the most severe risk factors for non-communicable diseases – one of the biggest global health problems to date. The TCRG has made it their mandate to disrupt one of the most lucrative global industries by monitoring and investigating the industry’s influence on health behaviour and critically examining their public intention of reducing harm from tobacco,” said Anna Gilmore, TCRG director in a press release, “We are thrilled to be the proud recipients of the EHFG´s first European Health Leadership Award”.

The TCRG was chosen from six shortlisted candidates all of which were said to have  demonstrated unique and innovative ideas to challenge the status-quo of health in Europe.

Image Credits: European Health Forum Gastein, European Health Forum Gastein, European Health Forum Gastein.