Inside EU Health: Fallout for Várhelyi; US trade barrier report; cost of Long COVID; 40% of 65+ consider themselves healthy; gaps in tobacco and nicotine rules

After the Easter break Vital Signs is back.

Fallout for Várhelyi from Hungarian elections?

Many of those who advanced their career under Viktor Orbán may feel uneasy today. EU Commissioner for Health and Animal Welfare, Olivér Várhelyi, may be one. Apart from all else, Hungary’s return to the EU mainstream was central to the campaign.

In his speech, Magyar called on Hungary’s head of state, Tamás Sulyok, as well as senior justice officials and other high officials appointed by Fidesz, to resign immediately, or they will be removed by the new government.

Várhelyi is already subject to an internal investigation by the European Commission following an independent investigation involving the redoubtable Direkt36 and others. He has denied any links with Hungary’s intelligence services, but in a Facebook post at the time of the revelations, Magyar said that he had not revealed the whole truth.

Hungarian spy activity allegations coincide with Health Commissioner’s time as Orban’s chief diplomat

Commissioner Várhelyi was Orban’s top EU ambassador during a period when Hungary was reportedly spying on the European institutions

Vital SignsCatherine Feore

US trade barrier report calls for greater access and transparency to the EU pharma market

The 2026 report on Foreign Trade Barriers by the Office of the United States Trade Representative (USTR) has identified Europe as a source of barriers to its pharmaceutical and medical device sectors.

At the core of US concerns is the lack of transparency and predictability in how EU member states regulate drug pricing and reimbursement.

A source of particular ire is the widespread use of “clawback” systems. These require pharmaceutical companies to reimburse governments when public drug spending exceeds predefined budget caps. While intended as cost-control tools, US stakeholders view them as punitive and structurally discouraging for innovation.

The report goes into more detail on fourteen EU countries: Austria, Belgium, Czechia, France, Germany, Greece, Hungary, Ireland, Italy, Poland, Romania, Slovakia, Spain and Sweden.

For example, in Italy, a budget cap in hospital settings led to €2 billion in repayments by pharmaceutical firms in 2024 alone and France’s ‘safeguard clause’ and “several” other mechanisms were considered to result in “excessive price cuts”. Other barriers include delays: reimbursement delays in Belgium can exceed 27 months; other countries are also accused of delaying access to innovative products.

Long COVID could cost as much as €115 billion per year

An OECD report, supported by EU funding, finds that long COVID remains a significant health and economic burden years after the pandemic. Although prevalence is expected to stay below 1% between 2025 and 2035, it will still affect millions across Europe, with direct healthcare costs estimated at €9.4 billion annually.

Indirect costs are far higher. Long COVID, marked by fatigue and cognitive issues, reduces workforce participation. About one in five affected workers face employment disruption, with productivity losses of up to 10% in the first year. This could result in GDP losses of 0.1–0.2%, or around €115 billion annually.

The report calls for better diagnosis, treatment, and co-ordinated policies across sectors, alongside stronger prevention efforts, including vaccination.

Long COVID could cost as much as €115 billion per year

An OECD report finds long COVID will continue to strain health systems and cut productivity, urging better care and cross-sector coordination to reduce its lasting economic impact

Vital SignsCatherine Feore

40% of people aged 65+ consider themselves healthy

A Eurostat survey in 2024 found that more than two-thirds (68.5%) of the EU population perceived their health as very good or good. The share was 91.3% among 16 to 24-year-olds.

Among people aged 65 and older, 40.0% perceived their health as very good or good. Ireland had the highest share of people who rated their health as very good or good (62.0%), followed by Belgium (57.4%) and Luxembourg (56.8%).

EU launches evaluation of gaps in current tobacco and nicotine rules

The European Commission fired the starting gun on the review of its main tobacco control rules expected later this year (2 April). A 144-page staff working document evaluating the existing regulatory framework, principally the Tobacco Products Directive (TPD) and Tobacco Advertising Directive (TAD), points to some achievements, but also shows how the legislation needs to be updated to fully account for novel products and aggressive digital marketing.

Tobacco-related deaths in the EU have declined by 8.6% since the 2012 revision, but smoking prevalence in the EU remains high. The emergence and widespread popularity of novel nicotine products, such as e-cigarettes and nicotine pouches, among young people, is causing alarm and a diversity of responses.

While the legislation has been successful in reducing promotion through more conventional channels such as television and via sponsorship of sporting events, the rapid evolution of digital marketing is bypassing conventional routes and finding new avenues through video games and influencers.

Belgian court ruling triggers vaccine blame game in Poland and Romania

The Brussels Court of First Instance has held (1 April) that Poland and Romania were contractually obliged to pay for €1.9 billion worth of vaccines ordered in 2021. Both current governments are considering appealing the decision while also placing the blame on former administrations.

Belgian court ruling triggers vaccine blame game in Poland and Romania

A Brussels court rules both Poland and Romania must honour binding vaccine contracts signed during the pandemic

Vital SignsCatherine Feore