Belgian civil-society organisations issue a call to the presidency of the Council of the EU.
Our drugs policy in Belgium and in Europe is at a turning point. Prices are rising, budgets are under pressure, shortages are increasing. If we do nothing, access to medicines is increasingly at risk—here in Belgium but also, and often moreso, in the rest of the world. During the coronavirus crisis, we saw how pharmaceutical companies did not want to guarantee accessibility.
Now reforms are on the way. The European Commission came out with a proposal in April 2023 that is being discussed further. What emphases will our Belgian government place during this presidency of the Council of the European Union?
We advocate a ‘fair pharma’ policy. That means at least the following eight points:—
- A fair price for new medication: the theory that a medication may cost whatever that furnishes to the company leads to excesses which are untenable. The price should be determined by the cost of research and production plus a reasonable profit margin. A model developed for this purpose by an international association of mutual-insurance companies should be used in future price negotiations.
- Fair information, more transparency: governments should oblige pharmaceutical companies to make available all information on the cost of research and development of a new drug. The European Commission only proposes to make public research funding public; that is not enough. The 2019 World Health Organization resolution on transparency contains a clear overview of the necessary measures. It must be implemented in full in Belgian and European legislation—at the Belgian level when deciding on reimbursement and at the European level during market authorisation.
- Fair prices and more transparency also mean no more secret contracts: these set member states against each other and undermine democratic control. European price negotiations will only resolve quickly when member states dare to take the first step to abolish secret contracts.
- Fair use of intellectual property: compulsory licensing should be adopted if companies refuse to adjust their price to a fair amount. Using, or threatening to use, compulsory licences strengthens our power at the negotiating table with pharmaceutical multinationals. But for this to happen, national legislation must be amended so that the minister of health also has the effective ability to grant such a compulsory licence, if he or she deems it a useful and necessary measure in exceptional circumstances.
- Fair innovation: governments must develop new funding models, such as de-linkage, which encourage research in those areas that have been publicly identified as priorities, regardless of the potential profit margin this may present to a pharmaceutical company. First and foremost, we think of the problem of growing antibiotic resistance. There is an urgent need for new antibiotics, which is not being sufficiently addressed by pharmaceutical companies.
- Fair taxation: during the Belgian presidency, work must continue on implementing the European agreement on a global minimum corporation tax. Even if the agreement could have been more ambitious, it is important that it is translated into domestic legislation as soon as possible. Too many loopholes remain that maintain tax favours and exemptions in our country, partly due to pressure from the large pharmaceutical companies. We advocate an effective tax rate of at least 15 per cent, with no exemptions.
- Fair and sufficient availability: more decisive measures are needed against the many occasions when drugs go out of stock. It is the responsibility of manufacturers and distributors to ensure continuous availability of our medication. The Belgian and European authorities must impose sanctions on companies which cannot, or do not sufficiently, justify why they can no longer provide a drug, temporarily or permanently. Pharmaceutical companies should be required to develop stricter prevention plans to manage and prevent shortages.
- Fair solidarity with the rest of the world: if our country effectively wants to make equal access to medicines worldwide a spearhead during the Belgian presidency, the above measures are indispensable. More transparency and fair prices in the countries of Europe will also benefit all other countries in the world. Moreover, we ask our country to support initiatives in favour of local production of vaccines, tests and medicines.
These demands are supported by the EPSU, the European Federation of Public Services Unions; the Belgian health mutualities CM-MC and Solidaris; the three Belgian trade-union confederations, ACV-CSC, ABVV-FGTB and ACLVB-CGLSB; the non-profit sector health unions PULS and CNE; 11.11.11, CNCD, Oxfam, WSM, Geneeskunde voor het volk, Viva Salud and Dokters van de Wereld—Médecins du monde.
Jan Willem Goudriaan has been general secretary of the European Federation of Public Service Unions (EPSU) since 2014.
Claude Rolin is chair of the board of the Belgian Christian health mutual-insurance association on the French- and German-speaking side.
Jean-Pascal Labille is general secretary of Solidaris, the Belgian socialist health mutual-insurance association.