Proposals that the European Medicines Agency (EMA) should be given the new role of comparing the relative effectiveness of new drugs - but not their cost - hold “a certain degree of appeal” for the industry, EFPIA’s new president, GlaxoSmithKline chief executive Andrew Witty said yesterday.

It is for the European Union (EU) member states to decide whether the EMA’s current role should be widened from approving new drugs to also providing an EU-wide ruling on their relative effectiveness, said Mr Witty. However, in his view there is appeal in having an evidence-based relative efficacy or effectiveness discussion just once in Europe, “rather than having it 27 times and potentially answered 27 different ways,” he told journalists during the EFPIA’s annual general meeting in London.

Provided it did not become a further reason to delay approval or access to the medicine, this is something the industry could work toward, he said, but stressed that cost-effectiveness decisions would still have to be made individually by each member state.

Discussing the recent round of drug price reductions imposed by European governments as they seek to tackle their soaring budget deficits, Mr Witty forecast that cuts in the EU this year will be “above trend,” compared to the annual average of around 3% in recent years. But he felt the last few months’ decisions on price cuts have shown a pretty high degree of restraint and concern about damaging innovation, with a recognition by politicians of the risk of doing permanent damage by taking measures which are too short-termist. “All I would ask of any government is don’t mistake ‘easy’ for ‘correct.’ Cutting medicines prices is a procurement decision but may not always be the best,” he said.

However, he added that, in his personal view, the decision by Novo Nordisk to remove some of its modern insulins from the Greek market following price cuts there was not necessarily helpful to the debate. The industry needs to be empathetic to the challenges being faced by payers, and “walking away from the table” is not necessarily the best policy, he said.

Prices of generics are still generally too high and will drop very significantly over the next five to six years, he forecast, adding that it is quite right that countries are beginning to focus more on the prices of older drugs, as this does not affect innovation.

The industry believes that decisions on the pricing of new medicines should follow a “holistic” approach which takes account of the product's broader benefits to society, and manufacturers need to be involved in these discussions, he said, and called for a “new dialogue” between governments and industry, both before and after marketing authoritisation is granted.

“Let’s start looking at medicines expenditure as an investment. This will enable governments and industry to set a strategic agenda for health and pharmaceutical innovation. What matters is whether a medicine works, responds to patient needs and, if so, that it is rewarded,” said Mr Witty.