Time to step up investments in health systems: EFPIA statement on the EU4Health Programme

As Europe is still fighting COVID-19 and facing its devastating effects on people and societies, we agree it is time to step up investments in our health systems to prevent future health crises and build a healthier and more resilient Europe for all.
EFPIA therefore welcomes the Commission’s proposal for an ambitious and self-standing funding programme for health, EU4Health, and its objectives to both strengthen the EU’s capacity to deal with serious health threats and to support Member States in investing in resilient health systems that improve outcomes and access for all people and patients.
The industry has worked continuously with the Commission and the EMA, as well as with national governments and authorities, to ensure the supply of medicines and continuity of clinical trials during the COVID-19 crisis. The crisis has revealed weaknesses which need to be addressed for the future when it comes to the capabilities of the EU to respond to serious health crisis together with Member States and stakeholders, and EFPIA therefore welcomes the focus on strengthening the Union’s crisis management capacities, including regarding actions to ensure the availability of medical products and relating to data gathering and analysis to project the demand of crisis relevant products during a crisis. Further to this we strongly support the calls for building more resilient healthcare systems. The pandemic has exposed the underlying fragility of many health systems within the EU, and we believe that it is imperative to futureproof systems against future shocks, including serious health threats such as the current pandemic. To this point, EFPIA welcomes any initiative which seeks to understand systematically what system level structures, policies, and funding models serve to create and sustain effective and resilient health care systems, including a system for rolling “stress tests” against potential future shocks.
Commenting on the programme, EFPIA Director General Nathalie Moll said: “EFPIA welcomes this much needed initiative and is looking forward to a comprehensive dialogue with the Commission, Member States and all stakeholders on how to address gaps and strengthen capabilities for responding to future health crises, building on lessons learned.”
It’s important to note that European health systems were in need of reform and strategic investment long before COVID-19, which is why the second objective of strengthening health systems is of equal importance. EFPIA specifically welcomes the objective to support policy-making and monitoring through high-quality, comparable and reliable data. The COVID-19 crisis has shown the challenges of collecting data comparable across Member States even on such a basic indicator as mortality. In order to improve our health systems we need to have much more granular and timely data on patient-relevant health outcomes readily available. This data should be standardised across Europe in order to be comparable across providers, regions and countries, and in this regard the EU must play an instrumental role in enabling the necessary investments in health informatics and implementation of data collection methods, procedures and analytics.
We also welcome the increased emphasis on EU actions in support of the prevention, early diagnosis and treatment of non-communicable, rare and complex diseases, as well as strengthening of national vaccination programmes. COVID-19 has highlighted the heightened risks for people living with one or several chronic diseases, and why it is of crucial importance to improve the prevention and treatment of these diseases, both for patients and in terms of health system resilience. Strategic investments in integrated care models, supported by Electronic Health Records, mhealth and telehealth solutions allowing patients to access their own health data and enabling home care solutions, will both improve the quality of life and care experience for patients, and free up resources in hospitals and other care settings. 
A long-term vision in healthcare also requires our systems are ready to support the timely access to advances in treatment and diagnostics so that patients can timely benefit from such innovations. The EU4Health programme could support Member States in developing and maintaining state of the art clinical trial networks and eco-systems which would help attracting clinical research (including through rapid advice and approval, remote consent, use of electronic monitoring and digital technologies and master protocols to align clinical trials and regulatory data). Investments in infrastructure, tools and methodologies to collect and analyse Real World Data would enable the assessment of the effectiveness of innovative therapies in clinical practice to inform decision-making, including for use in novel payment models such as outcomes-based contracts.   
As financing of health systems is primarily a Member State responsibility, the increased ambition from the side of the EU should be matched by an equally increased ambition from the national and regional level. If the crisis is followed by a period of reduced investment in health systems and innovation, we will once again find ourselves unprepared for a crisis like COVID-19. EFPIA welcomes that the Commission has laid out key reform needs in the recently published proposals for Country Specific Recommendations within the European Semester, e.g. relating to a sustainable workforce, strengthened primary care and e-health investments.
Though healthcare systems are primarily a Member State responsibility, some investments would clearly benefit from a common European approach. EFPIA recommends that the EU and Member States make a concerted and ambitious investment in a digital health infrastructure for Europe including through the recovery instrument Next Generation EU and the EU4Health programme. “What Europe needs in this moment is a “Digital Health Marshall Plan”, an ambitious investment that would not only strengthen the resilience of European health systems and enable patient-centred care, but also create an infrastructure for 21st century research and innovation in Europe” continued Nathalie Moll. “The COVID crisis has shown us the close link between health and wealth. This is the time to step up health investments in Europe.”