The European Commission should set up a publicly-accessible database which reveals the prices paid by member states for medicines, says the European Public Health Alliance (EPHA).

Pricing transparency is fundamental to ensuring that patients and stakeholders can make proper evaluations about equity and value for money in health systems, the EPHA tells the Commission, in its response to the public consultation on proposals to modernise the rules covering the transparency of EU member states' decisions on drug pricing and reimbursement; these are contained within Council Directive 89/105/EEC - the "Transparency Directive."

The Directive could establish a database, similar to that now operated by the World Health Organisation (WHO) in the Western Pacific Region, to provide comparative information on procurement prices for all medicines purchased by member states, the Alliance suggests. The website - which would also help to speed pricing decisions in countries which operate external reference pricing schemes - should be publicly accessible, include all medicines purchased each member state and be administered by the Commission, it recommends.

Drug prices are not currently transparent, says the advocacy group, pointing to the H1N1 pandemic in 2009, during which it says some EU member states had had secrecy clauses written into their contracts for procurement of vaccines, meaning that other member states, lacking full information, were unable to negotiate effectively for a fair price. "Such a situation is damaging to public health and should not be allowed to occur," it says.

The EPHA submission also points out that EU member states are already obliged to provide the Commission with a list detailing the medicines covered by their health insurance systems, together with the prices fixed by the national authorities, and suggests that these lists should be supplied twice a year, rather than annually as at present, in order to "aid health authorities to effectively negotiate with suppliers and ultimately to make medicines more affordable." 

It is also essential that the time periods for pricing and reimbursement decisions laid down in the Directive are adhered to, the Alliance tells the Commission.

"It is unacceptable from a public health standpoint that patients should not have access to medicines they need because of government inaction," it says, and also calls for "serious consideration" to be given to "the appropriateness of time limits for decisions with respect to generic medicines, where a decision has already been made for an originator medicine."

Once generics become available it is essential that they reach patients with the minimum of delay; the cost savings brought by genericsto both health systems and patients are now widely recognised, and are increasing in some states as a result of pro-active generic substitution policies, says the group.

"We believe that such demand-side measures should be transparent and that a level playing field in generic procurement in maintained. This is in the interest of a sustainable generics industry in Europe, which is necessary if we are to succeed in controlling pharmaceutical costs in the future," it adds.