Overview Of Reimbursement Status Of Disease-Modifying Therapies In EU4+UK Over The Past 3 Years And Upcoming Drugs
Author(s)
Sandra Garde, BPharm, Génova Ana, BSc, Grau César, BPharm, Susana Aceituno Mata, MSc, PhD, Àlex Casadevall-Nierga, BEng.
Evidenze Health, Barcelona, Spain.
Evidenze Health, Barcelona, Spain.
OBJECTIVES: To assess the extent of public reimbursement for disease-modifying therapies (DMTs) and compare price distribution across to better understand EU4+UK cross-country differences.
METHODS: Secondary literature review was conducted along with navigation of governmental websites and pricing databases to gather information on public reimbursement of DMT. The analysis calculated both the proportion of reimbursed DMTs across countries and the annual cost (52 weeks) of maintenance-phase for 12 DMTs approved for reimbursement in EU4+UK between 2022 and 2024.
RESULTS: Among the 12 DMTs reviewed, the cross-country analysis shows that Germany currently has the highest proportion of reimbursed DMTs (75%), and there is a noticeable trend toward lower prices. On the opposite end, Spain—where the reimbursement rate stands at 58%—emerges as the country with the highest listed prices. However, confidential discounts commonly applied to these innovative drugs in real-world practice may significantly reduce their actual cost. Meanwhile, the UK shows a reimbursement rate of 58.3% and Italy and France stand out as the countries with the fewest innovative drugs reimbursed (50%). In these countries, the prices offered are generally aligned. In many cases, delays in pricing and reimbursement processes are evident, as some medicines, despite being reimbursed, still do not have publicly available official prices.
CONCLUSIONS: European countries exhibit significant differences in their HTA processes, which impact reimbursement decisions, leading to notable inequities in access to DMTs. Moreover, the development of innovative DMTs has been steadily rising, with a clear upward trend over the observed years, and at least three new DMTs are expected among the upcoming launches in 2025.
METHODS: Secondary literature review was conducted along with navigation of governmental websites and pricing databases to gather information on public reimbursement of DMT. The analysis calculated both the proportion of reimbursed DMTs across countries and the annual cost (52 weeks) of maintenance-phase for 12 DMTs approved for reimbursement in EU4+UK between 2022 and 2024.
RESULTS: Among the 12 DMTs reviewed, the cross-country analysis shows that Germany currently has the highest proportion of reimbursed DMTs (75%), and there is a noticeable trend toward lower prices. On the opposite end, Spain—where the reimbursement rate stands at 58%—emerges as the country with the highest listed prices. However, confidential discounts commonly applied to these innovative drugs in real-world practice may significantly reduce their actual cost. Meanwhile, the UK shows a reimbursement rate of 58.3% and Italy and France stand out as the countries with the fewest innovative drugs reimbursed (50%). In these countries, the prices offered are generally aligned. In many cases, delays in pricing and reimbursement processes are evident, as some medicines, despite being reimbursed, still do not have publicly available official prices.
CONCLUSIONS: European countries exhibit significant differences in their HTA processes, which impact reimbursement decisions, leading to notable inequities in access to DMTs. Moreover, the development of innovative DMTs has been steadily rising, with a clear upward trend over the observed years, and at least three new DMTs are expected among the upcoming launches in 2025.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA263
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Disease
Biologics & Biosimilars, Rare & Orphan Diseases, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)