Access to medicines in countries participating in the WHO Small Countries Initiative: a report on progress, 2024
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World Health Organization. Regional Office for Europe
Abstract
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6 p.
Small countries in the WHO European Region face challenges in access to medicines owing to the small size of their pharmaceutical markets, low negotiating power and country-specific requirements – such as the need to produce tailored health technology assessments (HTAs), pricing and reimbursement dossiers, packaging and leaflets in local languages. These challenges are not new and considered in depth in a policy brief published in 2023 entitled, “Issues and challenges in access to medicines faced by small countries in the WHO European Region”. Proposed mechanisms such as the development of HTAs, managed entry agreements and horizon scanning processes require specialized resources and knowledge, which are often less available in small countries, leading to less favourable procurement terms for public payers. Strengthening and expanding financial protection through voluntary cooperation on joint horizon scanning, pooled demand and procurement, and HTA integration are promising strategies to help countries address these challenges. Areas of particular concern include access to medicines for rare diseases and cancer, and support to ensure that these are available for all patients who need them and affordable by all small countries. The WHO Regional Office for Europe’s Access to Novel Medicines Platform can provide support through identification of concrete actions to improve affordable and equitable patient access to effective, novel, high-cost medicines.
Small countries in the WHO European Region face challenges in access to medicines owing to the small size of their pharmaceutical markets, low negotiating power and country-specific requirements – such as the need to produce tailored health technology assessments (HTAs), pricing and reimbursement dossiers, packaging and leaflets in local languages. These challenges are not new and considered in depth in a policy brief published in 2023 entitled, “Issues and challenges in access to medicines faced by small countries in the WHO European Region”. Proposed mechanisms such as the development of HTAs, managed entry agreements and horizon scanning processes require specialized resources and knowledge, which are often less available in small countries, leading to less favourable procurement terms for public payers. Strengthening and expanding financial protection through voluntary cooperation on joint horizon scanning, pooled demand and procurement, and HTA integration are promising strategies to help countries address these challenges. Areas of particular concern include access to medicines for rare diseases and cancer, and support to ensure that these are available for all patients who need them and affordable by all small countries. The WHO Regional Office for Europe’s Access to Novel Medicines Platform can provide support through identification of concrete actions to improve affordable and equitable patient access to effective, novel, high-cost medicines.