The Tall Order of Drug Access and Affordability As Seen From The Alps

I was fortunate to attend the 18th European Health Forum in Gastein, Austria this month. The Forum, the leading health policy conference in Europe, is a non-partisan, non-profit association to advance health policy. Representatives from academia, government, patient groups, and industry from all over the continent come to the Alps – to tackle not the mountains, but rather, the tough issues facing the European health system.   This year’s theme was “Securing health in Europe. Balancing priorities. Sharing responsibilities.”

While the conference was focused on the wide range of topics affecting Europe, one of the main themes was a subject now near and dear to most Americans — new drug access and affordability. From a U.S. perspective, the Forum was especially timely since it occurred as the Turing Pharmaceuticals debacle unfolded in the U.S., Hillary Clinton challenged pharma companies to justify their prices, and the biotech market took a dive.

Europe clearly has its own distinct set of issues: a highly variable healthcare and payer system across countries, and now a massive influx of refugees, increasing pressure on already stressed healthcare resources. While there are differences, there are increasing similarities between Europe and the United States in terms of concern and criticism of drug prices.   In side conversations at the Forum, officials mused that the U.S. was finally asking the questions that they’d been asking in Europe for years. What is society willing to pay, or can afford to pay, when it comes to medicines?

It’s well known that in general, America pays substantially more than the rest of the world for specialty drugs. But relatively lower prices in Europe haven’t stemmed the criticism over the cost of drugs. In fact, at the conference, there was a steady stream of tweets from patient groups saying they wanted lower prices and greater transparency from pharma on how prices are set.

Notably, there were two things that appeared to be missing from the conference – and the larger societal debate as well. First, detailed discussions on ways to identify the real value of these new medicines; for that, thought leaders said, we will need a different framework, and more and better data.   This framework would encompass more than just the number of days, months, or years a patient may gain from a particular treatment; but, also, the treatment’s impact on quality of life, as well as its health and economic impact on the patient, the caregiver, and society as a whole.

The second missing piece: economic questions that are perhaps also philosophical ones. Will lower prices affect future scientific innovation? Does scientific innovation matter? Are we willing to live without it? And if not, who’s going to pay for it?

Another similarity between participants at the Forum and stakeholders in the U.S. – a call for collaboration with pharmaceutical companies as we debate these issues. For that, Gastein is a living example of how people from different areas and divergent points of view can come together and break bread while they discuss, debate, and hopefully advance these complex and critically important societal issues.

Of course, coming together is just a first step. Real progress on drug access will require fresh thinking and a commitment from all stakeholders to work together. It’s easy to criticize – much harder to come up with a solution.   But at least at Gastein, stakeholders are coming to the table.



Cindy DiBiasi has built a reputation as a leading health care communications consultant by working with top executives at some of the world’s largest companies. Cindy helps clients identify their communications strategy and develop messages on controversial healthcare issues. Her FDA consulting work includes leading clients through high-stakes FDA and Advisory Committee meetings. Cindy also leads 3D’s Market Access/Reimbursement communications work. Connect with Cindy on LinkedIn.