Europe’s health care challenges: rare diseases and orphan drugs in the limelight
The first colloquium devoted to the theme of health care in Europe under the French presidency of the European Union took place on 10 September at the Sorbonne University in Paris, and sought to define and prioritise the medical, economic and political challenges facing European healthcare. The first topic to be debated concerned access to expensive medicinal products. While close to 80% of medications are available in less-expensive generic forms, new products coming on the market are often very costly, and destined for small populations of patients - the very definition of an orphan drug. Several points arose on this topic, such as how to evaluate the service these innovative products provide society and determine their legitimate value. The expensive innovative products coming onto the market also highlight and aggravate the inequities existing within the EU, as a number of countries simply cannot assume the cost of reimbursing such treatments for their citizens. Gilles Pajot, of health industry intelligence provider IMS Health, demonstrated that the prices demanded for new products are directly correlated to market size. The linearity of the relationship between market size and price for these medicines explains the often-misunderstood reasons for the high price of orphan medicines. Pr. Laurent Degos of the French National Health Authority (HAS) placed the responsibility for the high prices of innovative medicines on the orphan drug regulation. However, this regulation does not impact the problematic of the consequences of small population samples on innovation costs. The representatives of the British health authority (NICE) and German equivalent (IQWIG) presented their decision process systems concerning reimbursement of innovative products. A solution may be to limit the collective resources for these products, which usually benefit the most gravely ill patients. However, such a highly political decision would require the involvement of all concerned parties.
The rest of the day was devoted to neglected diseases affecting developing countries, and European competitiveness in the international health industry. The colloquium was organised by the French Association of Pharmaceutical Laboratories (LEEM) and by IMS Health.