Lower-income EU countries are paying more for cancer medicines

A study, entitled “Price transparency of cancer medicines: a crucial step towards informed pricing negotiations in the European region”, involving 23 hospitals from nine European countries, reveals significant price variations for 15 cancer medicines both between and within countries. In some instances, hospitals are paying much more for the exact same medicine.

The European Cancer League, one of the network’s members, wrote: “Many hospitals across Europe are unknowingly paying far more than others. For example, hospitals in Hungary pay almost three times more than those in Germany for medication used to treat breast, colorectal, and gastric cancers.”

Guy Muller, who works with the Dutch Cancer Society, says the study challenges the widespread assumption that cancer drugs are always priced higher in countries with stronger economies: “In fact, countries with lower spending power often face higher hospital prices for cancer medicines. In Hungary, for example, hospitals negotiated an average price discount of -23% compared to Southern Europe (-38%) or the Netherlands (-33%).”

Critical Medicines Act

The Association of European Cancer Leagues (ECL) is calling for an ambitious Critical Medicines Act that “cements the use of joint procurement of medicines at the EU level, to help reduce prices, prevent shortages, and make smaller markets more attractive”. The pharma industry has been vocal in its opposition to more joint procurement at an EU level.

The ECL is also calling for an EU-wide price observatory with standardised, anonymised drug pricing data to improve hospitals and public authorities bargaining power. The study describes reference prices as poor proxies for actual transaction prices, saying that “hospitals often misjudged their relative negotiation performance”.

Reference pricing has been in the spotlight following US proposals for so-called “most-favoured nation” pricing, which benchmarks medicine prices in the US against those in comparable higher-income countries. The use of reference pricing, which does not take into account confidential discounts or negotiated net prices, might lead to inflated list prices and even greater opacity.

The study argues that greater alignment between reference and actual prices could increase the effectiveness of joint health technology assessment and coordinated pharmaceutical policy initiatives.

The study comes as the Council discusses its approach to the second round of trilogue negotiations on the Critical Medicines Act (16 March), with Parliament and Council positions still far apart.