EU payers are working together more closely in the National Competent Authorities on Pricing and Reimbursement (NCAPR) group!

EU payers are strengthening their collaboration through the National Competent Authorities on Pricing and Reimbursement (NCAPR) group. The European Commission has recognized the significance of this body in the EU Pharmaceutical Strategy, as stated in a recently published proposal for a new directive:

"While pricing and reimbursement decisions remain within the competence of Member States, the Pharmaceutical Strategy for Europe aims to enhance cooperation among Member States to improve affordability. The Commission has transformed the NCAPR from an ad-hoc forum into a continuous voluntary cooperation platform. The purpose is to facilitate the exchange of information and best practices on pricing, payment, and procurement policies, with the goal of enhancing the affordability and cost-effectiveness of medicines and ensuring the sustainability of health systems. The Commission is committed to strengthening this cooperation and supporting information exchange among national authorities, including on public procurement of medicines. It fully respects the competences of Member States in this area. Furthermore, the Commission may invite NCAPR members to participate in discussions of the Pharmaceutical Committee on topics that could impact pricing or reimbursement policies, such as market launch incentives."

According to the minutes of the NCAPR's December 2022 meeting, participants acknowledged the challenge posed by the interplay of limited evidence (resulting in high uncertainty) and high prices, particularly for orphan medicines. As a response, the NCAPR identified significant collaboration potential in establishing a demand-driven approach. In this approach, payers proactively identify unmet medical needs and define their willingness to pay upfront, thereby becoming active buyers. The group also emphasized the benefits of data sharing, including clinical data and information on willingness to pay and pricing and reimbursement status. Additionally, the potential for joint negotiations, horizon scanning, and procurement collaboration was highlighted.

The agenda for the NCAPR's March 2023 meeting sheds light on its priorities. The session commenced with presentations from the host TLV and DG SANTE on "advancing the affordability agenda." Subsequent discussions centered around the topic of "Willingness and ability to pay: what should payers (or buyers) be willing to pay for?" Another session examined the "Impact of inflation on pricing, reimbursement, and follow-up decisions," with an acknowledgment that companies often attempt to pass on their costs to consumers. The program also included a discussion on "Increasing competition among patented drugs."

Prominent speakers at the event included senior representatives from the European Commission, Ministries of Health, HTA agencies, health insurers, P&R authorities, procurement bodies, and the OECD.

Pharmaceutical companies should closely monitor this growing collaboration among payers as it is likely to shape the policies of Member States.

It is crucial for pharmaceutical companies to be aware of the increasing collaboration among payers within the NCAPR group, as this collaboration is expected to have a significant impact on the policies of Member States.

The closer cooperation among payers in the NCAPR group signifies a shift towards a more coordinated approach to addressing key challenges in pricing, reimbursement, and access to medicines. By sharing information and best practices, payers can learn from one another's experiences and explore innovative strategies to improve affordability and ensure the sustainability of healthcare systems.

The discussions held during the NCAPR meetings reflect the pressing issues faced by payers. The exploration of willingness and ability to pay highlights the need to define clear criteria for determining the value of new therapies and the thresholds for reimbursement. By aligning their perspectives on the value of medicines, payers can establish a more transparent and consistent approach to pricing and reimbursement decisions.

The consideration of the impact of inflation on pricing and reimbursement decisions acknowledges the financial challenges faced by payers as pharmaceutical companies seek to pass on their costs to consumers. Payers are increasingly seeking ways to mitigate the effects of rising prices and find strategies to ensure cost-effective access to innovative treatments.

The question of increasing competition among patented drugs underscores the importance of fostering a competitive market environment. By exploring measures to enhance competition, such as promoting generic competition, incentivizing biosimilars, or implementing pricing policies that reward therapeutic value, payers aim to create a more sustainable and cost-efficient market for pharmaceutical products.

The involvement of senior representatives from various stakeholders, including the European Commission, Ministries of Health, HTA agencies, health insurers, P&R authorities, procurement bodies, and the OECD, reflects the breadth of expertise and perspectives contributing to these discussions. The diverse range of participants ensures a comprehensive evaluation of issues and facilitates the development of well-rounded strategies.

As the collaboration among payers continues to evolve within the NCAPR group, pharmaceutical companies must stay informed and actively engage with payers to understand their priorities, concerns, and evolving expectations. By proactively participating in discussions and building relationships with key stakeholders, pharmaceutical companies can better navigate the changing landscape and align their strategies to meet payer requirements.

Ultimately, the growing collaboration among payers through the NCAPR group presents both challenges and opportunities for pharmaceutical companies. Those who proactively adapt to the changing dynamics and actively engage with payers will be better positioned to navigate the complexities of pricing, reimbursement, and access to medicines within the European market.

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