OBJECTIVES : To understand the “reality” of the pricing and reimbursement landscape for new products entering already competitive markets in 6 Eastern European countries and the increasing budgetary pressures being faced because of the COVID-19 pandemic.

METHODS : Desk research was performed to outline a benchmark HTA evaluation and market access landscape in each scope market (Hungary, Romania, Serbia, Slovenia, Croatia, Bulgaria). This was then tested with payers to understand if the processes outlined by national laws are implemented differently in real-world practice. 11 interviews with both national and local payers were completed across the six markets.

RESULTS : Our research highlighted that increasing budgetary pressures have led to an expectation of increased delays on reimbursement decisions in a number of Eastern European markets. The COVID-19 pandemic has put countries under a tremendous financial strain forcing resources that would be used elsewhere to be diverted towards the pandemic. This has caused budgets to be tightened and governments to deprioritise approval of new therapies in areas that have many existing treatments.

CONCLUSIONS : For new products that are entering competitive treatment spaces to successfully undergo pricing and reimbursement assessment processes in a prioritised and timely fashion, there is an increasing need for companies to demonstrate strong clinical and cost effectiveness data as well as considering other key factors that influence price and reimbursement decisions.