Brussels, 17 May – In a seminar hosted yesterday by the Group of the Progressive Alliance of Socialists & Democrats (S&D) in the European Parliament and the Member of the European Parliament (MEP) Alejandro Cercas (S&D, Spain), six MEPs from various political groups (1) along with representatives of governments, leading academics, researches and public health organisations (2) met to raise awareness about one of the most alarming issues that European healthcare systems face – the increasingly inadequate public access to medicines and its dire consequences. Speakers were brought together to discuss solutions that help make drugs accessible, affordable and available to the public.
Austerity policies are having a profound impact on the ability of many European public health systems to provide many of the necessary biomedical products for their citizens and residents. "European governments are using the current economic crisis to cut public spending across the board; decades of social justice are being swept away in a matter of a few years. What also raises eyebrows is the sense of arbitrarily that comes with the cuts - lifesaving medicines should have never made it into any cut list. Healthcare systems should be at the very bottom of the austerity list, not as a default option," said MEP Alejandro Cercas (S&D, Spain).
In her intervention, MEP Maria do Céu Patrão Neves (EPP, Portugal) put forward a proposal to ease the current scarcity of medicines in Europe. "Research and innovation will make the production of medicines increasingly sustainable and affordable, bringing prices down so people for whom medicines have become a luxury regain the lifesaving access today denied. In addition, a decisive and smart boost to research and innovation of medicines will help make them more effective, widening the diseases they covered.“
In her intervention, MEP Antonyia Parvanova (ALDE, Bulgaria) stressed how the European Parliament is becoming a battlefield between public interests and big pharma companies. "As the Parliament is debating three key directives related to public health -clinical trials, medical devices and price transparency- EU policy-makers must show that they are on the side of the people by putting their interests ahead of the industry’s profits," said Ms Parvanova.
On his side, MEP Nikos Chrysogelos (Greens/EFA, Greece) highlighted the need to make a better use of his country’s dwindling health budget. "In Greece, as in many other EU countries, improved efficiency should be a priority when adopting measures that fix all what is broken in our healthcare. The setup of Greece’s health system is deeply unfair in the way it allocates resources. If we are to rebuild a sustainable and capable healthcare model, thorough cost-benefit assessments are to be made the norm. Otherwise, the dire state of access to medicines in these times of crisis would only worsen."
MEP Marian Harkin (ALDE, Ireland) pointed to the excessively high cost of drugs in her native Ireland. “In spite of having several big pharma firms based in the country, the cost of many drugs in Ireland is up to three times the price paid in other European countries. Even if, to a large extent, the Irish healthcare system still functions reasonably well, the exceptional price of medicines is a huge burden on the individual and on the healthcare system that needs to be lifted."
When talking about the problems faced by Romania, MEP Minodora Cliveti (S&D, Romania) said that "in Romania there are problems related to access to medicines for uninsured individuals, and problems arising from the fact that in 2011 the conservative Romanian Government shut down 67 hospitals. These events have diminished peoples’ access both to quality healthcare and to the drugs they need to stay healthy – not to mention the Romanian citizens who do not receive quality healthcare when working in other countries of the EU."
Medicines shortages: curbing a damaging trend
Three elements determine whether or not a person obtains the medicine he needs; access, affordability and availability (3). As Europe’s population ages and the prevalence of non-communicable diseases goes up, the presence of these three factors increasingly translates into the difference between a healthy individual and a chronically-ill patient.
“The failure to consider the health consequences of austerity policies is preventing people from receiving essential medicines. Medicines are growing less affordable and increasingly hard to access for many. In particular, it has hit communities who are already affected by the crisis and the cuts and are struggling to put food on the table, let alone to pay for the medicines they need,” said Monika Kosińska, Secretary General of the European Public Health Alliance (EPHA).
Referring to the Spanish case, Joan Rovira, from the Department of Economic Theory at University of Barcelona, said that “disguising it as fiscal discipline, the Spanish government is shifting from a universal health system to a model where coverage is linked to employment. It recklessly excludes disadvantaged groups, like undocumented immigrants from receiving timely and adequate healthcare. As a result, the growing incidence of infectious diseases, like AIDS, will no doubt lead to increased health care costs.“
Further below you can read an extended version of this press statement (with additional quotes).
(1) Alejandro Cercas (S&D, Spain)[ [key note speech, in Spanish]; Maria do Céu Patrão Neves (EPP, Portugal); Antonyia Parvanova (ALDE, Bulgaria); Nikos Chrysogelos (Greens/EFA, Greece); Marian Harkin (ALDE, Ireland); Minodora Cliveti (S&D, Romania)
(2) European Public health Alliance (EPHA); the European Association of Hospital Pharmacists (EAHP); Transatlantic Consumer Dialogue (TACD); European AIDS Treatment Group (EATG); Health Action International Europe (HAI Europe); Pharmaceutical Group of the European Union (PGEU).
(3) [EPHA Briefing] Access to Medicines in Europe in Times of Austerity discusses the topic of access to medicines in the context of the economic crisis and considers three determinants; affordability and availability, in terms of access to medicines, and innovation in terms of developing new methods of assuring best possible health outcomes.
Javier Delgado Rivera, EPHA Communications Coordinator at firstname.lastname@example.org or +32(0) 2 230 3076.
Medicines shortages are not only spreading to every corner of the EU - they are also emerging in a growing number of medicines. “Evidence from the Pharmaceutical Group of the European Union (PGEU) members suggests that the problem affect countries from all corners of the EU and a wide variety of medicines. A number of PGEU members reports that the problem has got worse in the last 12 months. While the causes of shortages are attributable to a number of factors, including pricing policies and manufacturers’ issues, it is essential that patients are informed about actual and possible shortages and the likely duration of the problem. Additionally, stakeholders need to work together to make sure that this is the case,” said John Chave, Secretary General, Pharmaceutical Group of the EU.
Raminta Stuikyte, from the European AIDS Treatment Group, talked about the case of HIV/AIDS. " Cutting on HIV/AIDS prevention, shrinking budgets for medical tests and compromising treatments are not helping European governments fix their economic unbalances. If EU Member States are serious about streamlining their health systems, they would be better off by shifting the focus from measures that undermine people’s health to policies that address their healthcare underlining flaws, like the high price of certain life saving medicines."
Roberto Frontini, President of the European Association of Hospital Pharmacists (EAHP), stressed the upsetting scale of the lack of adequate drugs. “EAHP’s recent pan-European survey on medicines shortages clearly demonstrates that the shortages problem does not respect national borders and is affecting virtually every hospital in Europe. Immense amounts of hospital pharmacists’ time are being diverted from other elements of patient care to simply source medicines. With the evidence strongly suggesting the problem is becoming worse, doing nothing is no longer an option. Swift action is required.”
Over the course of the conference, it became clear that the EU would have to adopt a fresh policy approach that includes a better coordination among Member States and other stakeholders. For instance Horizon2020 provides a key opportunity to shape the legal framework governing EU funded research in a way that broad societal objectives are better fulfilled.
Talking about the enhanced role that the EU is urged to play, Tessel Mellema, from the Health Action International (HAI) Europe, highlighted that “the EU should step in and take the lead in the development of new models of biomedical innovation that promote both needs-driven innovation and affordable access to R&D outcomes. Pharma companies have gradually shifted their business model from focusing on therapeutic innovation, towards marketing, wider patenting, increased litigation against competitors and the development of ‘me too’ medicines of little therapeutic advantage. In the cases where new drugs deliver innovative therapeutic value, prices are sometimes too high for today’s shrinking health budgets.”
Several speakers agreed that national competent authorities should be placed in a stronger position to be able to negotiate prices when procuring medicines with the aim of facilitating the access by patients to high quality, efficient, safe, essential medicines.
According to David Hammerstein, from the Trans-Atlantic Consumer Dialogue, “the EU pharmaceutical model is dominated by massive marketing costs, poor results in innovation and very high prices artificially maintained.“
As Mr Hammerstein put it, “the current economic crisis has made the situation untenable. A European policy better equipped to fulfill public healthcare needs would include: a closer coordination among European countries in the public procurement of medicines; more flexible rules on Intellectual Property Rights (IPR) and anti-monopoly legislation both to promote generic competition and to boost imports; rules for social conditionality in the use of scientific results publicly funded; and a stricter regulation on transparency to better evaluate the real efficacy and safety of pharmaceuticals.“