OBJECTIVES: The objective was to understand pricing and market access implications in the EU considering potential price referencing by the US.

METHODS: A round-table discussion, with EU4 (Germany, France, Spain, Italy) policy makers, focused on outlining implications to European price levels and expected reactions to US price referencing. A pre-discussion survey was sent to gauge the initial perceptions of drug prices, likelihood of reference pricing reforms in the US, and expected impact on list-to-net price differential over the next 5 years. Results were aggregated and analyzed through the “triangulation method”.

RESULTS: List prices for pharmaceuticals in the US are considered high, however, policy makers believe that true net prices, in both the US and EU, are illusive due to the emergence confidential discounts/rebates and lack of pricing transparency in the EU. Although the EU would like to see greater price transparency among countries, price confidentiality will likely be maintained, according to the panelists. Furthermore, the panel believes that US pricing will continue to have minimum-to-no impact on EU pricing and access mechanisms. However, the policy makers expect pharmaceutical manufacturers to have a tighter pricing corridor between EU and US on a list-price basis, increased confidential discounting within EU, and opt out of launch in certain EU markets where the price is not in congruency with US price expectations.

CONCLUSIONS: Potential US reforms will likely disrupt global drug pricing. It is imperative to find methods which ensure patient access, while maintaining country budgetary requirements and incentivizing therapeutic innovation through manufacturer investment, research, and development of new pharmaceuticals. This will require various initiatives including innovative contracting strategies and platforms for improved communication amongst global stakeholders.