Pharma industry prepares for end of 'blockbuster medicines'

Christoph Thalheim, secretary-general of the European Multiple Sclerosis Platform (EMSP), said patient groups would welcome all kinds of research, whether it is directed towards common or rare diseases. 

He said people with rare diseases have been frustrated that treatments for their illnesses have not always been seen as worth investing in. Discussing the prospect of finding new applications for existing medicines, he highlighted growing interest in a blood pressure treatment which could help MS patients. 

Elizabeth Docteur, an independent health consultant formerly of the OECD, said innovation is critical in medicine but noted that the sector is markedly different to other industries. 

"When it comes to computers, innovation has made them faster and cheaper. But in healthcare, medicines have become better but are more expensive, and they take up an increasing proportion of spending," she said. 

Docteur said spending "smarter" will be crucial in order to get more in return for investment in medical innovation. She pointed to differences in drug costs across the EU, and said 80% of the price of medicines goes to the innovator in some countries, while in others, patent holders get just 50%. Where a large proportion of the price goes to wholesalers, retailers and the taxman, it provides less incentive for innovation. 

According to Docteur, governments should do their own cost-benefit analysis when setting a price for new innovative medicines. National authorities tend to follow the price of a new product in countries where it is initially launched, but companies have been savvy enough to select countries where they will get a favourable price for the launch. She said the EU can do more to support research comparing the true added value of a new drug. 

Bulgarian liberal MEP Antonyia Parvanova said much was being done to support innovation in the health sector, including the EU's Innovative Medicines Initiative and funding from the Framework Programme for Science and Research (FP7). 

She said in Israel, 10% of the health budget is earmarked for research and European governments could take a leaf out of Israel's book on this score. Parvanova also questioned the rationale of the French government spending €1.5 billion on swine flu medication while devoting just €770 million to cancer research. 

"When we talk about added value, we have to ask what will make a better contribution to public health so that we can strike the right balance," she said. 

On the issue of extending patents, Parvanova said any more in this direction would likely meet with resistance from generic companies who rely on off-patent medicines to make money. 

She was also critical of EU health ministers' failure to reach agreement on a proposal for cross-border healthcare at their meeting in Brussels on 1 December. "This was a very bad decision and sent the wrong message on the day the Lisbon Treaty came into force," she said. 

Wim Oosterom of PricewaterhouseCoopers said the discussion on innovation in healthcare should be broadened to include organisational innovation. He said investment in monitoring technology and efforts to increase patient compliance with medicines would lead to better value. 

Oosterom said treating and monitoring patients at home is cheaper for governments and preferred by patients, but hospitals have no incentive to switch from inpatient care to homecare. 

"One of the main hurdles to innovation in this area is that we currently pay providers [hospitals] instead of paying per patient. Why should a hospital pay for homecare if it means less money for the hospital? Money should follow the patient regardless of where they are treated," he said.