Strand 1: Local challenges, global learnings? What can other countries learn from best-practice examples in the field of pricing and reimbursement of medicines?

Description: A variety of pharmaceutical policies, including pricing and reimbursement measures, is used in national health systems to achieve equitable access to medicines for all patients at affordable costs. Even if there is no ‘one-size-fits-all’ model and policies have to be aligned to a country’s health system’s priorities, cross-country learning can be highly beneficial. Both good-practice examples as well as experiences of less successful policy implementations can guide policy-makers in developing their mix of policy options that is most appropriate to achieve a country’s defined policy objectives and to deal with current challenges (limited resources, high prices of medicines, non-availability of essential medicines, limited transparency, counterfeits, shortages). Lessons learned on established policies (such as external price referencing, introduction or change of the remuneration of pharmacies, generic policies, outpatient benefits package schemes) are of interest. In addition, sharing of experiences on more recent policies and models (e.g. measures to enhance the uptake of biosimilars, managed-entry agreements, collaborative approaches, horizon scanning, MCDA and other methodologies for evidence-informed decision-making) is highly appreciated.

In this strand we are looking for good-/best-practice examples in terms of increasing access and affordability of medicines, whose learning could be transferred to other setting. We are specifically interested in impact assessments and evaluations that analysed the effectiveness of policies. Success factors and supporting principles should be identified.

Strand 2: ‘Fake’ prices – Are price surveys still useful? The value of list prices against the backdrop of external price referencing and managed entry agreements.

Description: A frequently used policy to set pharmaceutical prices is external price referencing which usually refers to official list prices published by authorities in other countries. However, the value of this price information can be challenged since, particularly for high-priced medicines, their prices do not correspond to the ones paid by the health system: in several cases, public payers and purchasers (e.g. health insurance institutions, hospitals, etc.) negotiate confidential arrangements (managed-entry agreements) with pharmaceutical companies whose contents, especially the discounted prices, are kept confidential. The list prices, however, remain high (‘fake prices’). This impacts negatively on decision-making (use of artificially higher prices in external price referencing, distorting the balance in the pharmaceutical sector due to information asymmetry) and research (limiting the significance of medicine price studies). It has been argued that, despite their limitations, confidential deals allow health systems to improve access to medicines through obtaining lower prices, whereas others highlighted negative impacts on accessibility to medicines:
In this strand we specifically look for:

• studies and policy interventions that aimed to increase the transparency of ‘real’ prices;
• principles for developing a ‘fair price’;
• approaches of how to improve existing pricing and reimbursement policies that require price data (e.g. external price referencing, internal reference pricing, generic price link, etc.).

Strand 3: Fix the future? Innovative policy options need to be developed, agreed upon and implemented

Description: In recent years, some medicines with very high price tags entered the markets, and further promising though likely expensive therapies are said to be in the pipelines. Policy-makers have been increasingly worried about ensuring patient access, while at the same time safeguarding the long-term financial sustainability of their health systems and maintaining incentives for industry to encourage them in their investments for new medicines. It has been demonstrated that existing pricing, reimbursement and procurement policies all have their benefits and also limitations. New ideas and solutions of how to ensure access, affordability and incentives for innovation are needed, and they will likely go beyond pricing and reimbursement policies. Has the current business model come to an end? Which are the alternatives? Which tools and avenues for the future can be offered to support policy-makers to equip them for the challenges of the future (e.g. digitalisation of the health care sector and advances in the medical sector like gene sequencing and thera-pies)? In developing the future, how to ensure that patients and citizens are involved in a meaningful and serious manner? Which roles do financial investors play, how could their interest be aligned to public health priorities?
In this strand, we would like to receive contributions in relation to:

• innovative approaches in pricing and reimbursement policies and beyond; 
• assessment and discussion of new funding, payment and investment models (netflix model, amortization, value-based assessment approaches, horizon scanning, personalised medicines, etc.);
• collaborative approaches such as joint negotiations, joint procurement, information sharing, early dialogue and collaboration among the value chain.