02 June 2015

The European Association of Hospital Pharmacists (EAHP) has today highlighted the urgent need to create systems in Europe that will ensure sustainable and equitable access for patients to the medicines they need. EAHP has therefore published a new position paper on the topic of medicines pricing which was voted on and approved by its 34 member country associations.

The policy statement:

• urges health systems against shifting the burden of medicines cost directly towards the patient;
• calls for improved transparency in medicines pricing as necessary for effective scrutiny of public expenditure;
• supports efforts to achieve a greater match between a medicine's price and its value, and encourages the use of the hospital pharmacist's pharmacoeconomic expertise in this domain; and,
• expresses the need for impact assessment in respect of generic tendering, which in some cases has been linked to the creation of supply chain vulnerability by consequent reduction in market providers.

Dr Roberto Frontini, President of the European Association of Hospital Pharmacists, said:

"EAHP's activities in highlighting the problem of medicines shortages in Europe has drawn us inevitably to the topic of medicines pricing. In seeking to understand the factors that leave patients without medicines, issues of cost cannot be ignored. For this reason EAHP is seeking to promote public policy debate about how Europe pays for its medicines. Pushing cost towards patients undermines everything important in healthcare by financially punishing individuals for ill health. We need to understand where major cost burden is coming from, and that requires greater transparency.

Matching the cost of medicines to the value they deliver is clearly a complex and delicate task. The development of health technology assessment (HTA) protocols across Europe is therefore encouraging and the emerging skillsets of the hospital pharmacist in pharmacoeconomics has an important contribution to make.

Finally, while a continuous search for value for money in relation to medicines is necessary, care is also required to ensure that actions taken do not inadvertently lead to a significant reduction in the available providers of a medicine. This can create new supply chain vulnerabilities with consequent negative impacts for patient access.

With the right political will, and honesty and input from all stakeholders, there is reason to believe patient access to medicines can be put on a more stable footing for the future. However the debate should no longer be avoided."

The full EAHP policy statement on sustainable and equitable access to medicines is available here.

ENDS

For further information contact info[at]eahp[dot]eu 00 322 741 2436

NOTES TO EDITORS:

1. The European Association of Hospital Pharmacists (EAHP) is an association of national organisations across 34 countries representing hospital pharmacists at European and international levels. More information about the EAHP and its history here.
    
2. The full EAHP policy statement on sustainable and equitable access to medicines is available here. It was agreed via a unanimous vote of EAHP's member associations at the 2014 EAHP General Assembly in Sofia, Bulgaria.
    
3. Some useful case study information about the transfer of medicines cost burden to patients is provided in a briefing document by the European Public Health Alliance (EPHA) entitled "Access to Medicines in Europe in Times of Austerity". The annex includes descriptions of governments taking many medicines out of public coverage a well as policies being implemented to remove certain categories of patients from previously existing exemptions from co-payment. More information here. Research has shown that placing increased cost burden for medicines upon patients can result in them skipping doses or failing to take medication entirely. More information here. Placing greater cost burden for medicines towards patients also risks inadvertently encouraging individuals to look online for cheaper sources, with the risk that they obtain harmful counterfeit products. More information here.
    
4. For over a decade, organisations such as the World Health Organisation (WHO) have been calling for improvements in medicines pricing transparency as an important aspect in improving the landscape for accessibility to medicines (see World Health Assembly Resolution 54.11, 21 May 2001). Lack of transparency can lead to poorly informed procurement decisions, while improved transparency on prices can equip health systems, health professionals (including hospital pharmacists) in making better decision on cost-effective treatment options. More information here.
    
5. Health Technology Assessment (HTA) is an important tool for policy decision makers to allocate health resources efficiently by aiding value-based decision-making. Economic assessment of pharmaceuticals (pharmacoeconomic assessment) is a sub-discipline of HTA and describes the formal process of comparing the value of one pharmaceutical with another. By virtue of the nature of their profession, hospital pharmacists are especially interested in the economic efficiency of drugs as the hospital sector is an area where high cost drugs are widely prescribed. Hospital pharmacists are also particularly qualified to take on pharmacoeconomic roles in respect of their unique specialised understanding of medication. In developing HTA and pharmacoeconomics, health systems should leverage the hospital pharmacist resource in their midst.
    
6. In June 2013 the International Pharmaceutical Federation (FIP) held a Summit in Toronto on the topic of medicines shortages at which the participants discussed various cited causation factors. This included the unintended impacts that some national tendering procedures can produce by destabilising demand predictability for manufacturers of medicines with consequent negative impact on supply stability. The Toronto Summit therefore recommended: "responsible contracting is crucial to ensure healthy, fair competition and to avoid shortages in supply of medicines." More information here.
    
7. Requests for interviews with Dr Roberto Frontini can be made by contacting info[at]eahp[dot]eu | 00 322 741 2436