EFPIA welcomes the proposals for Country Specific Recommendations (CSRs) published by the European Commission as part of the European Semester 2016. The CSRs for 2016 not only continues the process of streamlining the European Semester to make it better targeted, but also strengthens follow-up and implementation.

EFPIA notes that the recommendations on health and healthcare systems continue largely to focus on fiscal sustainability and cost-containment. While we acknowledge the responsibility of the European Semester in ensuring long-term fiscal sustainability in Europe, EFPIA believes that a narrow focus on cost and cost-effectiveness is inappropriate when analysing Member States’ healthcare systems.

The reality suggests that meeting the common challenges of an ageing population and increased prevalence of chronic diseases, health- and social care systems require increased focus on delivering value-based health and social care services that deliver the highest health outcomes for patients for the money spent. This will require a clear understanding of which interventions that deliver the best health outcomes for patients so that resources can be allocated accordingly. Investing in comprehensive health information systems, with electronic health records and disease-based registries as core components, together with Health Systems Performance Assessment, is therefore important.  

EFPIA recognises that certain CSRs fall out of this scope. Some Member States, including Bulgaria, Cyprus, Latvia, Lithuania and Romania, are facing challenges such as low funding, high unmet medical needs and poor outcomes. EFPIA welcomes the conclusion that poor health outcomes are detrimental to economic growth and fiscal sustainability in the long term, and supports these comments and recommendations in general.

Regarding the Country Reports published earlier this year, EFPIA lauds recommendations that in certain cases focus on the structural factors of Healthcare Systems. These include the need: to reduce hospitalisation to curb costs; and for several countries to move from a hospital-centric system to one that focuses on primary and community care. More integrated and patient-centered care models could remove barriers between primary and secondary care services and thereby tackle the increasing burden on health systems from chronic diseases.

EFPIA asserts that, in addition to such structural changes, it is important to implement clinical guidelines and optimal care pathways for patients, based on the latest scientific and clinical knowledge on how to achieve the best possible health outcomes. Ideally, these guidelines would be supported by real-world data and updated regularly in line with best practice.

We would also underscore that investment may be required to reform health systems, to achieve long-term sustainability. As highlighted by the CSRs, certain countries may need to increase their health spend, including on prevention, in order to achieve healthier populations and sustainable finances over time. It is worth bearing in mind that health systems facing less pressing challenges today, will also have to invest to become fit for the future. A key target area for this would be information technology, which will offer an evidence basis for better clinical and resource allocation decisions.