With Donald Trump, Europeans’ entry to progressive medicines might be decreased | EUROtoday

HASToday, well being care spending within the United States is by far the very best amongst OECD nations. They characterize 16% of their gross home product, in comparison with 12% for France, the third nation by way of well being spending.

One of the primary explanations is the price of medicines. On common, American sufferers pay twice as a lot for his or her remedies as sufferers in different nations.

Prices negotiated between producers and personal insurers

Two causes permit us to grasp this example. On the one hand, though the Biden administration’s Inflation Reduction Act launched in 2022 the precept of value negotiation on the federal stage for some costly medication for retirees benefiting from the Medicare insurance coverage program, the vast majority of Price negotiations happen between producers and personal insurers. In comparability, these negotiations systematically contain nationwide authorities in European nations, whose negotiating energy is by definition stronger.

On the opposite hand, entry to the American market doesn’t suggest an analysis of the effectiveness of medicine, in contrast to European nations. In France, for instance, the High Authority for Health asks producers to display the associated fee/effectiveness ratio and the budgetary affect of the very best reimbursed medication. These evaluations assist inform value negotiations in mild of the financial affect of medicines.

For a number of a long time, the inflation of drug costs on the American market has not directly benefited European sufferers. Indeed, increased margins achieved within the United States permit producers to make higher business efforts in nations like France.

European sufferers, “stowaways”

This state of affairs was denounced by the earlier Trump administration, which described European sufferers as “free riders” within the financing of world therapeutic innovation, because the decrease costs practiced in Europe didn’t sufficiently help funding in analysis. and improvement of well being producers.

At the top of his earlier time period, Donald Trump signed an govt order whose goal was to implement a mannequin for setting drug costs based mostly on the so-called “most favored nation” criterion. This mannequin would have consisted of adopting for medication reimbursed beneath the Medicare program the bottom value charged in different world markets.

A reform of the worth negotiation framework

Although this presidential decree was by no means adopted – notably resulting from robust opposition throughout the Republican camp – it reveals President Trump’s political will to reform the framework for drug value negotiations. And he demonstrates a powerful break with the historic positioning of his get together, extra favorable to liberalism within the well being market. During his second time period, Donald Trump may thus try to make use of the authorized framework of the Inflation Reduction Act applied by his predecessor to reintroduce his challenge of setting a value ceiling based mostly on overseas costs.

ALSO READ The authorities is growing the worth of medicines… to keep away from shortagesThe consequence for European sufferers can be robust, as a result of it could actually result in extra tense value negotiations with producers and will in the end scale back entry to probably the most progressive merchandise. As a reminder, greater than 40% of the worldwide pharmaceutical market’s turnover is generated within the United States.

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Answer

More than ever, it raises the query of European sovereignty for entry to well being improvements. The member nations of the European Union have just lately adopted the precept of joint analysis of medicines, which can be applied from 2025. It might be assumed that higher coordination of European well being programs for market entry circumstances will definitely be mandatory sooner or later.

*Thomas Rapp is professor of economics at Paris-Cité University and holder of the Aging UP! chair. A former Harkness fellow at Harvard, he co-directs the Liepp well being coverage analysis axis at Sciences Po.