Background: The merits of greater or lesser net price transparency (NPT) for innovative medicines has been a topic of discussion for many years across policymakers, industry and civil societies. Perspectives amongst different stakeholders vary and, apparently, a consensus has not been achieved yet. To date, the debate has been primarily political, with less attention being paid to the technical aspects. This study aims to generate a consensus among academic experts on the consequences of NPT based on both theoretical and empiric evidence.

Methods: The study summarises the consensus reached during an advisory board with 12 economic and health economic experts from 12 European countries on the implications of greater NPT. Evidence presented for discussion during the advisory board consisted of 1) findings from an online qualitative survey to 16 payers from 10 countries; 2) findings from a systematic literature review; 3) insights from 1:1, 90-minute discussions held with each expert prior to the advisory board.

Results: While the views of many policymakers are largely supportive of greater NPT, payers surveyed expressed concerns about making their own prices transparent, underpinned by the belief that confidentiality allows for better prices and faster access to innovative medicines. Consensus amongst academic experts also indicated that – as a single measure – greater NPT in Europe is a risky and inefficient policy proposal to address challenges faced in the healthcare system based on the potential negative consequences of implementing greater NPT with regards to impacts on payer budgets, patient access and the functioning of the market.

Conclusions: The potential consequences of greater NPT in Europe show how important it is that policy change regarding NPT is based on the economics of pharmaceutical pricing and is evidence-based.