With one of the fastest-aging populations in the world, Europe will never be
this young again. By 2050, one in three Europeans will be 65 or older, an age
when Alzheimer’s disease risk starts doubling every five years. While
breakthrough treatments are changing the trajectory of Alzheimer’s disease in
other parts of the world, Europe is lagging in access and investment, cutting
many people off from care options that could improve their lives.
A global shift toward early intervention is showing what is possible, with
patients starting to be diagnosed in time for treatment to have an impact.[1],
[2] Detecting the disease early is like diagnosing cancer at stage one rather
than stage four. It can make a profound difference for patients and families in
the moments that matter most. Timely treatment can provide more independence,
connection and time to make informed choices.
> Detecting the disease early is like diagnosing cancer at stage one rather than
> stage four. It can make a profound difference for patients and families in the
> moments that matter most.
Worldwide, 23 regulators have approved disease modifying therapies for
Alzheimer’s disease, signaling growing confidence in these medicines. Four of
the world’s largest economies also provide reimbursement so that cost is not a
barrier. Yet in much of Europe, people living with the disease remain unable to
access these innovations. Some countries have authorized treatments but failed
to provide a reimbursement pathway, creating a two-tiered healthcare system
where wealthier patients can afford treatment while others are left behind.
Recent developments in the UK offer a cautiously encouraging signal. The appeal
process through the National Institute for Health and Care Excellence has
acknowledged that the full value of innovation, including the impact on unpaid
carers and the broader burden on informal carers, must be part of the
conversation. This is a welcome recognition that systems need to evolve. Health
technology assessment frameworks were largely designed to measure short-term,
direct healthcare costs for acute interventions. They recognize clinical benefit
in narrow terms, and overlook the wider impact that early intervention delivers
across health and social care systems:[3] fewer years in residential and nursing
home care and a reduced burden on unpaid carers. Such considerations matter
enormously to patients and families, yet their voice often remains unheard in
the decision-making of many European countries.
The cost of this miscalculation compounds. Families are denied treatments that
exist today, and future generations inherit health systems ill-equipped for the
challenge ahead.
Delay is already costing families and health systems
When systems delay action, the burden doesn’t disappear. It shifts to families
and it costs people good days with their loved ones.
Dementia carries the highest global burden of disability, stealing more total
years of quality life and independence than any other disease. Its economic toll
is staggering, costing Europe 40 percent more than all cancers combined. The
vast majority of those costs fall on families and social care. This also
increases sharply as the disease progresses, going up by approximately €25,000
more per year as it moves from mild to severe.[4]
Slowing disease progression eases the burden on millions of family members who
put aside their own careers and well-being to look after loved ones as
unpaid carers.[5] Yet the 90 percent of dementia costs that fall outside
direct healthcare are routinely excluded from value assessments. 4 Including
them would fundamentally change the equation.
New medicines to treat Alzheimer’s disease have achieved efficacy and safety
profiles on par with leading cancer and multiple sclerosis treatments, yet they
face more skepticism. 4 Part of the problem is that diseases long considered
untreatable suffer from underinvestment in care pathways. When treatments
finally arrive, it is families who bear the consequences of health systems that
are slow to adapt.
This is where leaders can act. When assessing whether these treatments are worth
paying for, policymakers must consider the full economic picture, one that
captures the long-term value that early intervention delivers, not just
short-term direct costs.
Science is moving. Europe can lead or fall behind.
At a time when European leaders are debating competitiveness, biotech leadership
and fiscal sustainability, Alzheimer’s disease is not just a health issue. It is
a test of whether Europe can adapt its systems to demographic reality, or allow
the gap between scientific progress and patient access to widen further.
European policymakers should give people this choice to know and act early. That
begins with two priorities: enabling access to innovative diagnostics and
treatments within a stronger system of care, and modernizing value assessment so
it captures the full benefit of innovation, accounting for long-term savings
across health and social care, not just short-term direct costs.
> Alzheimer’s disease is not just a health issue. It is a test of whether Europe
> can adapt its systems to demographic reality, or allow the gap between
> scientific progress and patient access to widen further.
By expanding diagnosis and access to innovation, Europe can help more people age
with dignity, while reinforcing its position as a destination for research,
clinical trials and long-term investment.
Europeans deserve the choice that science now makes possible. If leaders
recognize the need for change, the time to act on it is now.
--------------------------------------------------------------------------------
[1] Eckhardt, J. “Breakthroughs Changing The Diagnosis And Treatment Of
Alzheimer’s” Forbes (2025) Breakthroughs Changing The Diagnosis And Treatment Of
Alzheimer’s (Accessed March 15, 2026)
[2] Beasley, B. “I Caught My Alzheimer’s at 57, Early Enough to Intervene.” The
Wall Street Journal (2026).
https://www.wsj.com/opinion/i-caught-my-alzheimers-at-57-early-enough-to-intervene-15072207
(Accessed March 15, 2026)
[3] EFPIA. “Taking Action Together to Ensure a Brighter Today and Tomorrow for
People with Alzheimer’s Disease.” Position Paper.
https://www.efpia.eu/media/412735/taking-action-together-to-ensure-a-better-today-and-tomorrow-for-people-with-alzheimer-s-disease.pdf
[4] Frisoni GB, Aho E, Brayne C, et al. “Alzheimer’s disease outlook:
controversies and future directions.” The Lancet, Vol. 406, No. 10510, pp.
1424–1442 (September 2025).
[5] Abi-Saleh N, So D, Molenkamp V. “Addressing the Impact of Alzheimer’s
Disease on Care Capacity in the Netherlands: Implications for Health Technology
Assessment.” Poster presentation, ISPOR Europe 2025.
https://www.ispor.org/heor-resources/presentations-database/presentation-cti/ispor-europe-2025/poster-session-1-2/addressing-the-impact-of-alzheimer-s-disease-on-care-capacity-in-the-netherlands-implications-for-health-technology-assessment
--------------------------------------------------------------------------------
Disclaimer
POLITICAL ADVERTISEMENT
* The sponsor is Eli Lilly & Company.
* The entity ultimately controlling the sponsor is Eli Lilly & Company.
* This article calls on European policymakers to reform health technology
assessment and reimbursement systems to improve access to Alzheimer’s
diagnostics and treatments, explicitly aiming to influence public health
policy in Europe.
More information here.
Tag - patient access
Biotechnology is central to modern medicine and Europe’s long-term
competitiveness. From cancer and cardiovascular disease to rare conditions, it
is driving transformative advances for patients across Europe and beyond . 1
Yet innovation in Europe is increasingly shaped by regulatory fragmentation,
procedural complexity and uneven implementation across m ember s tates. As
scientific progress accelerates, policy frameworks must evolve in parallel,
supporting the full lifecycle of innovation from research and clinical
development to manufacturing and patient access.
The proposed EU Biotech Act seeks to address these challenges. By streamlining
regulatory procedures, strengthening coordination and supporting scale-up and
manufacturing, it aims to reinforce Europe’s position in a highly competitive
global biotechnology landscape .2
Its success, however, will depend less on ambition than on delivery. Consistent
implementation, proportionate oversight and continued global openness
will determine whether the a ct translates into faster patient access,
sustained investment and long-term resilience.
Q: Why is biotechnology increasingly seen as a strategic pillar for Europe’s
competitiveness, resilience and long-term growth?
Gilles Marrache, SVP and regional general manager, Europe, Latin America, Middle
East, Africa and Canada, Amgen: Biotechnology sits at the intersection of
health, industrial policy and economic competitiveness. The sector is one of
Europe’s strongest strategic assets and a leading contributor to research and
development growth . 3
At the same time, Europe’s position is under increasing pressure. Over the past
two decades, the EU has lost approximately 25 percent of its global share of
pharmaceutical investment to other regions, such as the United States and
China.
The choices made today will shape Europe’s long-term strength in the sector,
influencing not only competitiveness and growth, but also how quickly patients
can benefit from new treatments.
> Europe stands at a pivotal moment in biotechnology. Our life sciences legacy
> is strong, but maintaining global competitiveness requires evolution .” 4
>
> Gilles Marrache, SVP and regional general manager, Europe, Latin America,
> Middle East, Africa and Canada, Amgen.
Q: What does the EU Biotech Act aim to do and why is it considered an
important step forward for patients and Europe’s innovation ecosystem?
Marrache: The EU Biotech Act represents a timely opportunity to better support
biotechnology products from the laboratory to the market.
By streamlining medicines’ pathways and improving conditions for scale-up and
investment, it can help strengthen Europe’s innovation ecosystem and accelerate
patient access to breakthrough therapies. These measures will help anchor
biotechnology as a strategic priority for Europe’s future — and one that can
deliver earlier patient benefit — so long as we can make it work in practice.
Q: How does the EU Biotech Act address regulatory fragmentation, and where will
effective delivery and coordination be most decisive?
Marrache: Regulatory fragmentation has long challenged biotechnology development
in Europe, particularly for multinational clinical trials and innovative
products. The Biotech Act introduces faster, more coordinated trials, expanded
regulatory sandboxes and new investment and industrial capacity instruments.
The proposed EU Health Biotechnology Support Network and a u nion-level
regulatory status repository would strengthen transparency and
predictability. Together, these measures would support earlier regulatory
dialogue, help de-risk development and promote more consistent implementation
across m ember s tates.
They also create an opportunity to address complexities surrounding combination
products — spanning medicines, devices and diagnostics — where overlapping
requirements and parallel assessments have added delays.5 This builds on related
efforts, such as the COMBINE programme,6 which seeks to streamline the
navigation of the In Vitro Diagnostic Regulation , 7 Clinical Trials Regulation8
and the Medical Device Regulation9 through a single, coordinated assessment
process.
Continued clarity and coordination will be essential to reduce duplication and
accelerate development timelines .10
Q: What conditions will be most critical to support biotech
scale-up, manufacturing and long-term investment in Europe?
Marrache: Europe must strike the right balance between strategic autonomy and
openness to global collaboration. Any new instruments under the Biotech Act
mechanisms should remain open and supportive of all types of biotech
investments, recogni z ing that biotech manufacturing operates through globally
integrated and highly speciali z ed value chains.
Q: How can Europe ensure faster and more predictable pathways from scientific
discovery to patient access, while maintaining high standards of safety and
quality?
Marrache: Faster and more predictable patient access depends on strengthening
end-to-end pathways across the lifecycle. The Biotech Act will help ensure
continuity of scientific and regulatory experti z e, from clinical development
through post-authori z ation. It will also support stronger alignment with
downstream processes, such as health technology assessments, which are
critical to success.
Moreover, reducing unnecessary delays or duplication in approval processes can
set clearer expectations, more predictable development timelines and earlier
planning for scale-up.
Gilles Marrache, SVP and regional general manager, Europe, Latin America,
Middle East, Africa and Canada, Amgen. Via Amgen.
Finally, embedding a limited number of practical tools (procedural, digital or
governance-based) and ensuring they are integrated within existing European
Medicines Agency and EU regulatory structures can help achieve faster
patient access . 11
Q: What role can stronger regulatory coordination, data use and public - private
collaboration play in strengthening Europe’s global position in biotechnology?
Marrache: To unlock biotechnology’s full potential, consistent implementation is
essential. Fragmented approaches to secondary data use, divergent m ember
state interpretations and uncertainty for data holders still limit access to
high-quality datasets at scale. The Biotech Act introduces key building blocks
to address this.
These include Biotechnology Data Quality Accelerators to improve
interoperability, trusted testing environments for advanced innovation, and
alignment with the EU AI Act ,12 European Health Data Space13 and wider EU data
initiatives. It also foresees AI-specific provisions and clinical trial guidance
to provide greater operational clarity.
Crucially, these structures must simplify rather than add further layers of
complexity.
Addressing remaining barriers will reduce legal uncertainty for AI deployment,
support innovation and strengthen Europe’s competitiveness.
> These reforms will create a moderni z ed biotech ecosystem, healthier
> societies, sustainable healthcare systems and faster patient access to the
> latest breakthroughs in Europe .” 14
>
> Gilles Marrache, SVP and regional general manager, Europe, Latin America,
> Middle East, Africa and Canada, Amgen.
Q: As technologies evolve and global competition intensifies, how can
policymakers ensure the Biotech Act remains flexible and future-proof?
Marrache: To remain future-proof, the Biotech Act must be designed to evolve
alongside scientific progress, market dynamics and patient needs. Clear
objectives, risk-based requirements, regular review mechanisms and timely
updates to guidance will enhance regulatory agility without creating unnecessary
rigidity or administrative burden.
Continuous stakeholder dialogue combined with horizon scanning will be essential
to sustaining innovation, resilience and timely patient access over the long
term. Preserving regulatory openness and international cooperation will be
critical in avoiding fragmentation and maintaining Europe’s credibility as a
global biotech hub.
Q: Looking ahead, what two or three priorities should policymakers focus on to
ensure the EU Biotech Act delivers meaningful impact in practice?
Marrache: Looking ahead, policymakers should focus on three priorities for the
Biotech Act:
First, implementation must deliver real regulatory efficiency, predictability
and coordination in practice.
Second, Europe must sustain an open and investment-friendly framework that
reflects the global nature of biotechnology.
And third, policymakers should ensure a clear and coherent legal framework
across the lifecycle of innovative medicines, providing certainty for the use
of artificial intelligence — as a key driver of innovation in health
biotechnology.
In practical terms, the EU Biotech Act will be judged not by the number of new
instruments it creates, but by whether it reduces complexity, increases
predictability and shortens the path from scientific discovery to patient
benefit.
An open, innovation-friendly framework that is competitive at the global level
will help sustain investment, strengthen resilient supply chains and deliver
better outcomes for patients across Europe and beyond.
--------------------------------------------------------------------------------
References
1. Amgen Europe, The EU Biotech Act Unlocking Europe’s Potential, May 2025.
Retrieved from
https://www.amgen.eu/media/press-releases/2025/05/The_EU_Biotech_Act_Unlocking_Europes_Potential
2. European Commission, Proposal for a Regulation to establish measures to
strengthen the Union’s biotechnology and biomanufacturing sectors, December
2025. Retrieved from
https://health.ec.europa.eu/publications/proposal-regulation-establish-measures-strengthen-unions-biotechnology-and-biomanufacturing-sectors_en
3. EFPIA, The pharmaceutical sector: A catalyst to foster Europe’s
competitiveness, February 2026. Retrieved from
https://www.efpia.eu/media/zkhfr3kp/10-actions-for-competitiveness-growth-and-security.pdf
4. The Parliament, Investing in healthy societies by boosting biotech
competitiveness, November 2024. Retrieved from
https://www.theparliamentmagazine.eu/partner/article/investing-in-healthy-societies-by-boosting-biotech-competitiveness#_ftn4
5. Amgen Europe, The EU Biotech Act Unlocking Europe’s Potential, May 2025.
Retrieved from
https://www.amgen.eu/docs/BiotechPP_final_digital_version_May_2025.pdf
6. European Commission, combine programme, June 2023. Retrieved from
https://health.ec.europa.eu/medical-devices-topics-interest/combine-programme_en
7. European Commission. Medical Devices – In Vitro Diagnostics, March 2026.
Retrieved from
https://health.ec.europa.eu/medical-devices-vitro-diagnostics_en
8. European Commission, Clinical trials – Regulation EU No 536/2014, January
2022. Retrieved from
https://health.ec.europa.eu/medicinal-products/clinical-trials/clinical-trials-regulation-eu-no-5362014_en
9. European Commission, Simpler and more effective rules for medical devices –
Commission proposal for a targeted revision of the medical devices
regulations, December 2025. Retrieved from
https://health.ec.europa.eu/medical-devices-sector/new-regulations_en#mdr
10. Amgen Europe, The EU Biotech Act Unlocking Europe’s Potential, May 2025.
Retrieved from
https://www.amgen.eu/docs/BiotechPP_final_digital_version_May_2025.pdf
11. AmCham, EU position on the Commission Proposal for an EU Biotech Act
12. European Commission, AI Act | Shaping Europe’s digital future, June 2024.
Retrieved from
https://digital-strategy.ec.europa.eu/en/policies/regulatory-framework-ai
13. European Commission, European Health Data Space, March 2025. Retrieved from
https://health.ec.europa.eu/ehealth-digital-health-and-care/european-health-data-space-regulation-ehds_en
14. The Parliament, Why Europe needs a Biotech Act, October 2025. Retrieved
from
https://www.theparliamentmagazine.eu/partner/article/why-europe-needs-a-biotech-act
--------------------------------------------------------------------------------
Disclaimer
POLITICAL ADVERTISEMENT
* The sponsor is Amgen Inc
* The ultimate controlling entity is Amgen Inc
* The political advertisement is linked to advocacy on the EU Biotech Act.
More information here.
The humanitarian crisis in Gaza is “still catastrophic” and has seen only a
“marginal” improvement since the ceasefire, with worse to come due to the Middle
East war, senior World Health Organization officials told reporters Thursday.
There are $6 million worth of medicines that can’t reach Gaza due to supply
disruptions in the Middle East, Hanan Balkhy, WHO director for the Eastern
Mediterranean region, said. The chaos “will take away, for sure, from the
support needed for the people in Gaza,” she said.
Israel closed border crossings in and out of Gaza after striking Iran last
weekend, claiming the enclave had adequate humanitarian supplies and there would
be “no impact on the humanitarian situation.” Israel said Tuesday it would
reopen the crossing to allow for the “gradual entry of humanitarian aid,”
reported Le Monde with AFP.
Balkhy, however, said the volume of aid entering Gaza “was and is not enough,”
while WHO Director-General Tedros Adhanom Ghebreyesus said the improvement since
the ceasefire was “actually marginal.”
“We need 600 trucks to cross into Gaza every single day but currently it’s not
more than between 100 and 150,” Tedros said, adding the border closures had
interrupted “good progress” on the number of medical evacuations.
“I would like to use this opportunity actually to ask Israel to allow us to take
patients [from Gaza] to east Jerusalem and [the] West Bank,” Tedros said. Some
of the trucks entering Gaza were “commercial” and didn’t really help people who
couldn’t afford the supplies, he said.
POLITICO contacted Israel’s Coordinator of Government Activities in the
Territories for comment, but did not receive an immediate response.
Today, cancer remains one of Europe’s leading causes of death and disability,
accounting for 23 percent of all deaths in 2022 and 17 percent of
disability-adjusted life years in 2021. Four Europeans are diagnosed with cancer
every minute, a number that is expected to rise over the next several decades
due to population aging.
As the EU Beating Cancer Plan reaches the end of its initial phase, Europe now
stands at a critical moment. The question is not whether progress has been made,
but whether Europe will build on that momentum or allow it to stall, with
consequences not only for health outcomes, but also for economic growth and
scientific leadership.
Gilles Marrache
At this juncture, cancer care must be understood not as a cost to be contained,
but also as a strategic investment that delivers measurable returns in survival,
productivity and Europe’s global competitiveness.
> Continued investment in oncology is therefore not only a moral imperative but
> also a proven economic and social multiplier.
Cancer innovation delivers proven returns
Investment in cancer innovation has already delivered extraordinary value for
European patients and societies. Since 1989, advances in oncology have helped
prevent an estimated 5.4 million deaths. More recently, since 2012, innovative
cancer medicines have generated approximately 1.1 million quality-adjusted life
years, all while accounting for just 6.6 percent of total health budgets.
These gains are not abstract. They represent longer lives, improved quality of
life, and the ability for people to remain active contributors to their
families, workplaces and communities. Continued investment in oncology is
therefore not only a moral imperative but also a proven economic and social
multiplier.
Delayed access is holding Europe back
Despite these returns, Europe continues to struggle with timely access to
innovative cancer medicines and diagnostics. According to EFPIA’s 2025 W.A.I.T.
data, only 46 percent of centrally approved innovative medicines are available
to patients on average across Europe, with a mean delay of 578 days between EU
approval and patient access.
In oncology, these waits have grown since 2023, which undermines patient
outcomes and weakens Europe’s competitiveness in health innovation.
Europe’s innovation edge is at risk
Without decisive action, Europe risks falling further behind other regions.
High-income European countries currently invest roughly half as much per capita
in innovative medicines as the United States. This gap is driven largely by
differences in how new therapies are valued, assessed and reimbursed.
The impact of this underinvestment is already visible. Over the past two
decades, Europe has lost around a quarter of its global share of
biopharmaceutical research and development. Along with that loss comes fewer
high-quality jobs, reduced private investment and weakened strategic autonomy in
a sector that is increasingly central to economic and health security.
> evidence suggests that every euro invested in health can generate up to four
> euros in economic value, unlocking an estimated €10 trillion in GDP and saving
> up to 60 million lives.
Smart health investment drives growth and resilience
By increasing targeted investment in innovative medicines, including in
oncology, Europe can improve health outcomes for citizens, support workforce
participation and stimulate sustainable economic growth. Globally, evidence
suggests that every euro invested in health can generate up to four euros in
economic value, unlocking an estimated €10 trillion in GDP and saving up to 60
million lives.
What European policymakers should do next
To support oncology patients and safeguard innovation, regional and national
governments must act across policy, funding and access:
— Value what matters: modernize health technology assessment frameworks to
better capture the full societal and economic benefits of innovation, while
reducing duplicative and inefficient evidence requirements. This is particularly
important as oncology products begin going through the new EU Joint Clinical
Assessment.
— Accelerate access: introduce time-bound, predictable pricing and reimbursement
pathways; address regional and formulary-level delays; and invest in diagnostic
and biomarker testing capacity to ensure patients receive the right treatment at
the right time.
— Back prevention and screening: fully finance the EU Beating Cancer Plan’s
screening ambitions and scale proven pilot programmes that detect cancer earlier
and improve outcomes.
— Invest in innovation: increase public spending on innovative medicines in line
with their true societal impact, while eliminating clawbacks and other
cost-containment measures that disproportionately undermine the value of these
therapies.
A defining choice for Europe
Europe stands at a crossroads. It can choose to invest now in cancer innovation,
which would help to close survival gaps, strengthen competitiveness and deliver
long-term value for citizens. Or it can allow delays, underinvestment and
fragmented policies to widen those gaps further.
Aligning policy, funding and access around innovation would not only improve
cancer outcomes but make health one of Europe’s most powerful and sustainable
investments for the future.
--------------------------------------------------------------------------------
POLITICAL ADVERTISEMENT
* The sponsor is European Federation of Pharmaceutical Industries and
Associations (EFPIA)
* The political advertisement is linked to advocacy on securing a
technology-neutral EU road-transport decarbonisation framework through
recognition of renewable fuels, strengthened grid and infrastructure
enablers, and avoiding mandates that limit operators’ choice and
competitiveness.
* The ultimate controlling entity is European Federation of Pharmaceutical
Industries and Associations (EFPIA)
More information here.
Europe’s ambition to become climate neutral by 2050 cannot succeed in healthcare
unless we fix a basic problem: we do not measure sustainability in the same way
across the single market.
Currently, measuring Product Carbon Footprints (PCF) and Life Cycle Assessments
(LCA) throughout the European Union consists of a patchwork of national
methodologies and/or competing frameworks. This fragmentation is not just a
technical inconvenience, it actively undermines fair procurement, increases
costs, and risks unequal patient access across Europe.[1] Without a single,
harmonized methodology or framework, this EU sustainability and competitiveness
goal will remain challenging to achieve.
Though the lack of harmonizsation may seem technical, its consequences are
tangible. PCF and LCA outputs can differ widely depending on the standards and
methodologies defined and endorsed by policymakers, the way they are applied by
industry, or how existing international standards are interpreted and
implemented across member states.[2] The result is that national authorities are
effectively speaking different languages. A treatment considered more
environmentally responsible in one country may be evaluated entirely differently
just across the border. And without harmonized sustainability assessments for
medicines, there is a risk that sustainability is given disproportionate weight
compared with safety and quality, undermining high-quality medicine development.
In short, fragmentation slows progress, weakens trust and, importantly, –
prevents comparability. [1]
> In short, fragmentation slows progress, weakens trust and, importantly, –
> prevents comparability.
In practice, the absence of a harmonized standard allows 27 different
interpretations of ‘sustainability’ to coexist, which is incompatible with a
functioning single market.
Fortunately, PAS 2090:2025 offers what the EU has been missing: a single,
science-based methodology that allows regulators, procurers, and industry to
finally speak the same language. Developed with stakeholders across the
healthcare and life sciences sector, PAS 2090:2025 specifies the appropriate
methodology for medicines under ISO standards, aligning the playing field for
everyone involved. Published by the British Standards Institution in November
2025, it reflects broad technical consensus and strong credibility. PAS
2090:2025 provides the first practical methodology for measuring the
environmental performance of pharmaceuticals, establishing a common framework to
support comparable environmental reporting, reduce regulatory duplication and
provide policymakers with a credible basis to demonstrate progress toward
climate neutrality. It also gives industry the predictability needed to invest
in sustainable innovation, while ensuring that patients receive consistent
assessments of a treatment’s environmental profile, regardless of where it is
evaluated.
Importantly, this approach reflects principles already embedded in EU
policymaking. The European Health Data Space, for example, demonstrates how
interoperability and standardized frameworks are essential in making
cross-border data meaningful and actionable.[3] Meanwhile, the European
Commission has been equally clear: harmonized technical standards and coherent
sustainability rules are critical to the effective functioning of the Single
Market and ensuring the free movement of goods.[4]
This is a shared concern across stakeholder groups. Both the Federation of
European Academies of Medicine and European Academies’ Science Advisory Council,
representing Europe’s leading academies of medicine and science, have similarly
highlighted the fact that common standards are essential for transparent
procurement and fair competition across therapeutic categories.[5]And the
innovative pharmaceutical industry, via the European Federation of
Pharmaceutical Industries and Associations, has outlined both the challenges
caused by the absence of harmonized standards and called for policymakers,
regulators and healthcare stakeholders to endorse PAS 2090:2025 as the one,
internationally accepted standard for measuring PCA and LCA in the
pharmaceutical industry.[6]Europe’s leading academies of medicine and science,
the European Commission, and the innovative pharmaceutical sector all point to
the same conclusion: without harmonized standards, sustainability policy cannot
work.
> At Chiesi, we support PAS 2090:2025 not because it is convenient, but because
> it makes our environmental performance directly comparable and therefore
> accountable.[2]
That is why our teams have laid out ambitious, yet reachable, targets regarding
the reduction of Scope 1, 2 and 3 greenhouse gas emissions. We also know that in
order to reach these targets, we need to measure our actions and emissions.
Measuring what matters is the foundation to making a meaningful difference.[3]
> Measuring what matters is the foundation to making a meaningful
> difference.[3]
Our support for PAS 2090:2025 reflects a commitment to transparency,
science-based decision-making and long-term sustainability; we use it ourselves
because we believe it is the way forward — making it simple to compare products
fairly, design transparent tenders, and procure with clarity. Further, industry
members will be able to innovate with confidence, knowing that the life-changing
efforts will be assessed with science and clear understandings. That said, no
single actor can deliver alignment alone. Real progress depends on collaboration
between regulators, policymakers, scientific bodies, and industry around a
shared approach to measuring and comparing environmental impact.
Chiesi stands ready to work with policymakers and partners across the healthcare
ecosystem in favor of the adoption of PAS 2090:2025, understanding that
achieving true regulatory harmonization is essential for ensuring patient
access, maintaining high safety and quality standards, and fostering a globally
competitive pharmaceutical industry in Europe.
At the end of the day, the EU does not need another pilot program, framework, or
national workaround. It needs a decision. It needs action. Europe must agree on
how sustainability in healthcare is measured consistently and credibly across
the single market. Measuring what matters, in the same way across Europe, is the
only path to a climate-neutral, competitive, and fair European health system.
Endorsing PAS 2090:2025 as the reference methodology would turn that principle
into practice.
Andrea Bonetti
Andrea Bonetti is head of the EU office at Chiesi Farmaceutici, where he
oversees the company’s public affairs strategy at European level across
healthcare, sustainability and planetary health. Since opening Chiesi’s Brussels
office in 2020, he has strengthened the company’s engagement with EU
institutions, contributed to key policy discussions and supported initiatives to
advance awareness on climate and environmental priorities in line with Chiesi’s
values. He collaborates closely with cross-functional teams on the development
and implementation of Chiesi’s sustainability strategy and represents the
company within European and international trade associations. With more than 15
years of experience in health and environmental policy, he supports Chiesi’s
external positioning and contributes to sector-wide work on environmental and
sustainability frameworks.
Disclaimer:
POLITICAL ADVERTISEMENT
* The sponsor is Chiesi Farmaceutici
* The political advertisement is linked to advocacy on EU sustainability and
Single Market policy.
More information here.
--------------------------------------------------------------------------------
[1] European Commission. (2023). Annual Single Market Report 2023.
https://single-market-economy.ec.europa.eu/system/files/2023-01/ASMR%202023.pdf
[2] Healthcare Without Harm. (2022). Report: Procuring for greener pharma.
https://europe.noharm.org/media/4639/download?inline=1
[3] European Union. (2025). Regulation (EU) 2025/327 of the European Parliament
and of the Council of 11 February 2025 on the European Health Data Space and
amending Directive 2011/24/EU and Regulation (EU) 2024/2847.
https://eur-lex.europa.eu/eli/reg/2025/327
[4] European Commission. (2026). Public procurement.
https://single-market-economy.ec.europa.eu/single-market/public-procurement_en
[5] European Academies’ Science Advisory Council (EASAC) & Federation of
European Academies of Medicine (FEAM). (2021). Decarbonisation of the health
sector: A commentary by EASAC and FEAM.
https://easac.eu/fileadmin/PDF_s/reports_statements/Health_Decarb/EASAC_Decarbonisation_of_Health_Sector_Web_9_July_2021.pdf.pdf
[6]European Federation of Pharmaceutical Industries and Associations (EFPIA).
(2025). Advancing environmental sustainability assessment of pharmaceuticals
through standardisation and harmonisation of product carbon footprint
assessment.
https://www.efpia.eu/news-events/the-efpia-view/efpia-news/advancing-environmental-sustainability-assessment-of-pharmaceuticals-through-standardisation-and-harmonisation-of-product-carbon-footprint-assessment/
--------------------------------------------------------------------------------
STRASBOURG — The European Parliament has voted today to set up an EU fund to
expand access to abortion for women across the bloc, in a historic vote that
divided lawmakers.
The plan would establish a voluntary, opt-in financial mechanism to help
countries provide abortion care to women who can’t access it in their own
country and who choose to travel to one with more liberal laws. European
citizens presented the plan in a petition — through the campaign group “My
Voice, My Choice.”
Lawmakers in Strasbourg voted 358 in favor and 202 against the proposal, and 79
MEPs abstained.
The topic sparked animated discussions in the European Parliament plenary on
Tuesday evening. MEPs with center-right and far-right groups tabled competing
texts to the resolution put forward by Renew’s Abir Al-Sahlani on behalf of the
women’s rights and gender equality committee.
Supporters of the scheme argued it would help reduce unsafe abortions and ensure
women across the bloc have equal rights; those who oppose it, mostly from
conservative groups, dismissed it as an ideological push and EU overreach into
national policy.
Abortion laws vary greatly across the EU, from near-total bans in Poland and
Malta to liberal rules in the Netherlands and the U.K. The fund could be a game
changer for the thousands of European women who travel every year to another EU
country to access abortion care.
The European Commission now has until March 2026 to give a response.
This story is being updated.
Disclaimer
POLITICAL ADVERTISEMENT
* The sponsor is Zentiva
* The advertisement is linked to policy advocacy around the challenges faced by
the off-patent medicines industry, in particular the Urban Wastewater
Treatment Directive.
More information here
Thirty-six million Europeans — including more than one million in the Nordics[1]
— live with a rare disease.[2] For patients and their families, this is not just
a medical challenge; it is a human rights issue.
Diagnostic delays mean years of worsening health and needless suffering. Where
treatments exist, access is far from guaranteed. Meanwhile, breakthroughs in
genomics, AI and targeted therapies are transforming what is possible in health
care. But without streamlined systems, innovations risk piling up at the gates
of regulators, leaving patients waiting.
Even the Nordics, which have some of the strongest health systems in the world,
struggle to provide fair and consistent access for rare-disease patients.
Expectations should be higher.
THE BURDEN OF DELAY
The toll of rare diseases is profound. People living with them report
health-related quality-of-life scores 32 percent lower than those without.
Economically, the annual cost per patient in Europe — including caregivers — is
around €121,900.[3]
> Across Europe, the average time for diagnosis is six to eight years, and
> patients continue to face long waits and uneven access to medications.
In Sweden, the figure is slightly lower at €118,000, but this is still six times
higher than for patients without a rare disease. Most of this burden (65
percent) is direct medical costs, although non-medical expenses and lost
productivity also weigh heavily. Caregivers, for instance, lose almost 10 times
more work hours than peers supporting patients without a rare disease.[4]
This burden can be reduced. European patients with access to an approved
medicine face average annual costs of €107,000.[5]
Yet delays remain the norm. Across Europe, the average time for diagnosis is six
to eight years, and patients continue to face long waits and uneven access to
medications. With health innovation accelerating, each new therapy risks
compounding inequity unless access pathways are modernized.
PROGRESS AND REMAINING BARRIERS
Patients today have a better chance than ever of receiving a diagnosis — and in
some cases, life-changing therapies. The Nordics in particular are leaders in
integrated research and clinical models, building world-class diagnostics and
centers of excellence.
> Without reform, patients risk being left behind.
But advances are not reaching everyone who needs them. Systemic barriers
persist:
* Disparities across Europe: Less than 10 percent of rare-disease patients have
access to an approved treatment.[6] According to the Patients W.A.I.T.
Indicator (2025), there are stark differences in access to new orphan
medicines (or drugs that target rare diseases).[7] Of the 66 orphan medicines
approved between 2020 and 2023, the average number available across Europe
was 28. Among the Nordics, only Denmark exceeded this with 34.
* Fragmented decision-making: Lengthy health technology assessments, regional
variation and shifting political priorities often delay or restrict access.
Across Europe, patients wait a median of 531 days from marketing
authorization to actual availability. For many orphan drugs, the wait is even
longer. In some countries, such as Norway and Poland, reimbursement decisions
take more than two years, leaving patients without treatment while the burden
of disease grows.[8]
* Funding gaps: Despite more therapies on the market and greater technology to
develop them, orphan medicines account for just 6.6 percent of pharmaceutical
budgets and 1.2 percent of health budgets in Europe. Nordic countries —
Sweden, Norway and Finland — spend a smaller share than peers such as France
or Belgium. This reflects policy choices, not financial capacity.[9]
If Europe struggles with access today, it risks being overwhelmed tomorrow.
Rare-disease patients — already facing some of the longest delays — cannot
afford for systems to fall farther behind.
EASING THE BOTTLENECKS
Policymakers, clinicians and patient advocates across the Nordics agree: the
science is moving faster than the systems built to deliver it. Without reform,
patients risk being left behind just as innovation is finally catching up to
their needs. So what’s required?
* Governance and reforms: Across the Nordics, rare-disease policy remains
fragmented and time-limited. National strategies often expire before
implementation, and responsibilities are divided among ministries, agencies
and regional authorities. Experts stress that governments must move beyond
pilot projects to create permanent frameworks — with ring-fenced funding,
transparent accountability and clear leadership within ministries of health —
to ensure sustained progress.
* Patient organizations: Patient groups remain a driving force behind
awareness, diagnosis and access, yet most operate on short-term or
volunteer-based funding. Advocates argue that stable, structural support —
including inclusion in formal policy processes and predictable financing — is
critical to ensure patient perspectives shape decision-making on access,
research and care pathways.
* Health care pathways: Ann Nordgren, chair of the Rare Disease Fund and
professor at Karolinska Institutet, notes that although Sweden has built a
strong foundation — including Centers for Rare Diseases, Advanced Therapy
(ATMP) and Precision Medicine Centers, and membership in all European
Reference Networks — front-line capacity remains underfunded. “Government and
hospital managements are not providing resources to enable health care
professionals to work hands-on with diagnostics, care and education,” she
explains. “This is a big problem.” She adds that comprehensive rare-disease
centers, where paid patient representatives collaborate directly with
clinicians and researchers, would help bridge the gap between care and lived
experience.
* Research and diagnostics: Nordgren also points to the need for better
long-term investment in genomic medicine and data infrastructure. Sweden is a
leader in diagnostics through Genomic Medicine Sweden and SciLifeLab, but
funding for advanced genomic testing, especially for adults, remains limited.
“Many rare diseases still lack sufficient funding for basic and translational
research,” she says, leading to delays in identifying genetic causes and
developing targeted therapies. She argues for a national health care data
platform integrating electronic records, omics (biological) data and
patient-reported outcomes — built with semantic standards such as openEHR and
SNOMED CT — to enable secure sharing, AI-driven discovery and patient access
to their own data
DELIVERING BREAKTHROUGHS
Breakthroughs are coming. The question is whether Europe will be ready to
deliver them equitably and at speed, or whether patients will continue to wait
while therapies sit on the shelf.
There is reason for optimism. The Nordic region has the talent, infrastructure
and tradition of fairness to set the European benchmark on rare-disease care.
But leadership requires urgency, and collaboration across the EU will be
essential to ensure solutions are shared and implemented across borders.
The need for action is clear:
* Establish long-term governance and funding for rare-disease infrastructure.
* Provide stable, structural support for patient organizations.
* Create clearer, better-coordinated care pathways.
* Invest more in research, diagnostics and equitable access to innovative
treatments.
Early access is not only fair — it is cost-saving. Patients treated earlier
incur lower indirect and non-medical costs over time.[10] Inaction, by contrast,
compounds the burden for patients, families and health systems alike.
Science will forge ahead. The task now is to sustain momentum and reform systems
so that no rare-disease patient in the Nordics, or anywhere in Europe, is left
waiting.
--------------------------------------------------------------------------------
[1]
https://nordicrarediseasesummit.org/wp-content/uploads/2025/02/25.02-Nordic-Roadmap-for-Rare-Diseases.pdf
[2]
https://nordicrarediseasesummit.org/wp-content/uploads/2025/02/25.02-Nordic-Roadmap-for-Rare-Diseases.pdf
[3]
https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf
[4]
https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf
[5]
https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf
[6]
https://www.theparliamentmagazine.eu/partner/article/a-competitive-and-innovationled-europe-starts-with-rare-diseases?
[7]
https://www.iqvia.com/-/media/iqvia/pdfs/library/publications/efpia-patients-wait-indicator-2024.pdf
[8]
https://www.iqvia.com/-/media/iqvia/pdfs/library/publications/efpia-patients-wait-indicator-2024.pdf
[9]
https://copenhageneconomics.com/wp-content/uploads/2025/09/Copenhagen-Economics_Spending-on-OMPs-across-Europe.pdf
[10]
https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf
Disclaimer
POLITICAL ADVERTISEMENT
* The sponsor is Alexion Pharmaceuticals
* The entity ultimately controlling the sponsor: AstraZeneca plc
* The political advertisement is linked to policy advocacy around rare disease
governance, funding, and equitable access to diagnosis and treatment across
Europe
More information here.
This article is presented by EFPIA with the support of AbbVie
I made a trip back to Europe recently, where I spent the vast majority of my
pharmaceutical career, to share my perspectives on competitiveness at the
European Health Summit. Now that I work in a role responsible for supporting
patient access to medicine globally, I view Europe, and how it compares
internationally, through a new lens, and I have been reflecting further on why
the choices made today will have such a critical impact on where medicines are
developed tomorrow.
Today, many patients around the world benefit from medicines built on European
science and breakthroughs of the last 20 years. Europeans, like me, can be proud
of this contribution. As I look forward, my concern is that we may not be able
to make the same claim in the next 20 years. It’s clear that Europe has a
choice. Investing in sustainable medicines growth and other enabling policies
will, I believe, bring significant benefits. Not doing so risks diminishing
global influence.
> Today, many patients around the world benefit from medicines built on European
> science and breakthroughs of the last 20 years
I reflect on three important points: 1) investment in healthcare benefits
individuals, healthcare and society, but the scale of this benefit remains
underappreciated; 2) connected to this, the underpinning science for future
innovation is increasingly happening elsewhere; and 3) this means the choices we
make today must address both of these trends.
First, let’s use the example of migraine. As I have heard a patient say,
“Migraine will not kill you but neither [will they] let you live.”[1]
Individuals can face being under a migraine attack for more than half of every
month, unable to leave home, maintain a job and engage in society.[2] It is the
second biggest cause of disability globally and the first among young women.[3]
It affects the quality of life of millions of Europeans.[4] From 2011-21 the
economic burden of migraine in Europe due to the loss of working days ranged
from €35-557 billion, depending on the country, representing 1-2 percent of
gross domestic product (GDP).[5]
Overall socioeconomic burden of migraine as percentage of the country’s GDP in
2021
Source: WifOR, The socioeconomic burden of migraine. The case of 6 European
Countries.5
Access to effective therapies could radically improve individuals’ lives and
their ability to return to work.[6] Yet, despite the staggering economic and
personal impacts, in some member states the latest medicines are either not
reimbursed or only available after several treatment failures.[7] Imagine if
Europe shifted its perspective on these conditions, investing to improve not
only health but unlocking the potential for workforce and economic productivity?
Moving to my second point, against this backdrop of underinvestment, where are
scientific advances now happening in our sector?
In recent years it is impressive to see China has become the second-largest drug
developer in the world,[8] and within five years it may lead the innovative
antibodies therapeutics sector,[9] which is particularly promising for complex
areas like oncology.
Cancer is projected to become the leading cause of death in Europe by 2035,[10]
yet the continent’s share of the number of oncology trials dropped from 41
percent in 2013 to 21 percent in 2023.10
Today, antibody-drug conjugates are bringing new hope in hard-to-treat tumor
types,[11] like ovarian,[12] lung[13] and colorectal[14] cancer, and we hope to
see more of these advances in the future. Unfortunately, Europe is no longer at
the forefront of the development of these innovations. This geographical shift
could impact high-quality jobs, the vitality of Europe’s biotech sector and,
most importantly, patients’ outcomes. [15]
> This is why I encourage choices to be made that clearly signal the value
> Europe attaches to medicines
This is why I encourage choices to be made that clearly signal the value Europe
attaches to medicines. This can be done by removing national cost-containment
measures, like clawbacks, that are increasingly eroding the ability of companies
to invest in European R&D. To provide a sense of their impact, between 2012 and
2023, clawbacks and price controls reduced manufacturer revenues by over €1.2
billion across five major EU markets, corresponding to a loss of 4.7 percent in
countries like Spain.[16] Moreover, we should address health technology
assessment approaches in Europe, or mandatory discount policies, which are
simply not adequately accounting for the wider societal value of medicines, such
as in the migraine example, and promoting a short-term approach to investment.
By broadening horizons and choosing a long-term investment strategy for
medicines and the life science sector, Europe will not only enable this
strategic industry to drive global competitiveness but, more importantly, bring
hope to Europeans suffering from health conditions.
AbbVie SA/NV – BE-ABBV-250177 (V1.0) – December 2025
--------------------------------------------------------------------------------
[1] The Parliament Magazine,
https://www.theparliamentmagazine.eu/partner/article/unmet-medical-needs-and-migraine-assessing-the-added-value-for-patients-and-society,
Last accessed December 2025.
[2] The Migraine Trust;
https://migrainetrust.org/understand-migraine/types-of-migraine/chronic-migraine/,
Last accessed December 2025.
[3] Steiner TJ, et al; Lifting The Burden: the Global Campaign against Headache.
Migraine remains second among the world’s causes of disability, and first among
young women: findings from GBD2019. J Headache Pain. 2020 Dec 2;21(1):137
[4] Coppola G, Brown JD, Mercadante AR, Drakeley S, Sternbach N, Jenkins A,
Blakeman KH, Gendolla A. The epidemiology and unmet need of migraine in five
european countries: results from the national health and wellness survey. BMC
Public Health. 2025 Jan 21;25(1):254. doi: 10.1186/s12889-024-21244-8.
[5] WifOR. Calculating the Socioeconomic Burden of Migraine: The Case of 6
European Countries. Available at:
[https://www.wifor.com/en/download/the-socioeconomic-burden-of-migraine-the-case-of-6-european-countries/?wpdmdl=358249&refresh=687823f915e751752703993].
Accessed June 2025.
[6] Seddik AH, Schiener C, Ostwald DA, Schramm S, Huels J, Katsarava Z. Social
Impact of Prophylactic Migraine Treatments in Germany: A State-Transition and
Open Cohort Approach. Value Health. 2021 Oct;24(10):1446-1453. doi:
10.1016/j.jval.2021.04.1281
[7] Moisset X, Demarquay G, et al., Migraine treatment: Position paper of the
French Headache Society. Rev Neurol (Paris). 2024 Dec;180(10):1087-1099. doi:
10.1016/j.neurol.2024.09.008.
[8] The Economist,
https://www.economist.com/china/2025/11/23/chinese-pharma-is-on-the-cusp-of-going-global,
Last accessed December 2025.
[9] Crescioli S, Reichert JM. Innovative antibody therapeutic development in
China compared with the USA and Europe. Nat Rev Drug Discov. Published online
November 7, 2025.
[10] Manzano A., Svedman C., Hofmarcher T., Wilking N.. Comparator Report on
Cancer in Europe 2025 – Disease Burden, Costs and Access to Medicines and
Molecular Diagnostics. EFPIA, 2025. [IHE REPORT 2025:2, page 20]
[11] Armstrong GB, Graham H, Cheung A, Montaseri H, Burley GA, Karagiannis SN,
Rattray Z. Antibody-drug conjugates as multimodal therapies against
hard-to-treat cancers. Adv Drug Deliv Rev. 2025 Sep;224:115648. doi:
10.1016/j.addr.2025.115648. Epub 2025 Jul 11. PMID: 40653109..
[12] Narayana, R.V.L., Gupta, R. Exploring the therapeutic use and outcome of
antibody-drug conjugates in ovarian cancer treatment. Oncogene 44, 2343–2356
(2025). https://doi.org/10.1038/s41388-025-03448-3
[13] Coleman, N., Yap, T.A., Heymach, J.V. et al. Antibody-drug conjugates in
lung cancer: dawn of a new era?. npj Precis. Onc. 7, 5 (2023).
https://doi.org/10.1038/s41698-022-00338-9
[14] Wang Y, Lu K, Xu Y, Xu S, Chu H, Fang X. Antibody-drug conjugates as
immuno-oncology agents in colorectal cancer: targets, payloads, and therapeutic
synergies. Front Immunol. 2025 Nov 3;16:1678907. doi:
10.3389/fimmu.2025.1678907. PMID: 41256852; PMCID: PMC12620403.
[15] EFPIA, Improving EU Clinical Trials: Proposals to Overcome Current
Challenges and Strengthen the Ecosystem,
efpias-list-of-proposals-clinical-trials-15-apr-2025.pdf, Last accessed December
2025.
[16] The EU General Pharmaceutical Legislation & Clawbacks, © Vital
Transformation BVBA, 2024.
With multiple legislative processes underway, we are now in an important moment
for Europe’s ambition to boost access and be a global leader in innovation. An
agile, modernized regulatory system — coupled with supportive intellectual
property and access policies — can attract research and development and advanced
manufacturing to Europe. This will contribute to the earlier availability of new
cures for European patients and a healthier innovative ecosystem.
Unfortunately, today we see that Europe is falling behind global competition.
Over the last decade, there has been a 10 percent decrease in clinical trials in
the European Union, which has led to 60,000 fewer European patients
participating in trials.[1] Europe’s fragmented system for clinical trial
approvals is a leading cause of this decline, impacting early access to
innovative treatments. As scientific breakthroughs can deliver better health
outcomes for patients, governments need to keep pace with this speed of
innovation.
> Draghi report on EU competitiveness importantly identified pharmaceutical
> innovation as a strategic sector for growth in Europe. That said, the report
> also noted that what is missing is a simple and strong execution plan behind
> it, with simplified regulation and coherent and predictable policies that
> could drive the European goals of increased competitiveness and strategic
> autonomy.
Europe’s marketing authorisation process now exceeds 14 months (444 days),
causing patients to wait nearly three months longer than in the US (356 days)
and over five months longer than in Japan (290 days) for access to innovative
medicines.[2] Such delays, combined with complex and lengthy country-level
market access systems, mean patients in Europe are waiting an average of 20
months longer than people living in the United States to benefit from scientific
innovation.[3]
Last year’s Draghi report on EU competitiveness importantly identified
pharmaceutical innovation as a strategic sector for growth in Europe. That said,
the report also noted that what is missing is a simple and strong execution plan
behind it, with simplified regulation and coherent and predictable policies that
could drive the European goals of increased competitiveness and strategic
autonomy.
Ongoing discussions on the revision of the General Pharmaceutical Legislation
and the In Vitro Diagnostic Regulation (IVDR), the Critical Medicines Act and
the upcoming Biotech Act (Part 1) mark crucial opportunities for Europe to
become a global leader for innovation. However, to make this vision a reality,
the EU must address structural challenges that undermine innovation and patient
access to novel, lifesaving medicines.
> To reverse the worrying decline in European clinical trial activity, the EU
> should implement a maximum two-month approval process for clinical trial
> applications (CTAs), encompassing the reviews of both regulators and ethics
> committees consistent with other global leaders.
The successful implementation of structural, future-proof policy changes can
ensure timely access to innovative medicines for EU citizens, and this can be
achieved through five key policy recommendations:
Facilitate and accelerate clinical trial applications
To reverse the worrying decline in European clinical trial activity, the EU
should implement a maximum two-month approval process for clinical trial
applications (CTAs), encompassing the reviews of both regulators and ethics
committees consistent with other global leaders. It is equally important to
increase collaboration among EU member states to remove unique and specific
national CTA requirements and questions, and to also introduce opportunities for
an informal dialogue with regulators to expediently address smaller challenges
that can be quickly fixed. Legislative overlaps and fragmentation between the
Clinical Trials Regulation (CTR) and the IVDR should also be addressed to avoid
delays in clinical trials that utilize companion diagnostics.
Expand expedited pathways
Despite their potential, the EU’s expedited pathways (such as the European
Medicines Agency’s PRIME scheme for unmet medical needs, Conditional Marketing
Authorisation and Accelerated Assessment) are underutilised, limiting rapid
patient access to important medicines. Similar expedited pathways are widely
used by other regulators around the world, like the United States and Japan.
Expanding the use of expedited pathways in the EU to new indications and
aligning eligibility criteria with global standards would ensure that the EU has
more competitive regulatory pathways and earlier patient access to life-saving
medicines.
Shorten scientific advice and approval timelines
Shortening the EU’s scientific advice procedure is critical to optimise the
development of innovative products, ensure timely and efficient resource
management for both applicants and regulators, and maintain the EU’s influence
in global scientific and clinical research. By evolving to a more integrated and
agile dialogue, the EU can provide comprehensive, consistent guidance throughout
the product lifecycle and remain competitive with other regions. Given their
growing number, scientific advice should be available for medicines used with
all types of medical devices and in vitro diagnostics (including combinations
diagnostics) to address the complexities of working across these regulatory
frameworks.
> An agile, modernized regulatory system — coupled with supportive intellectual
> property and access policies — can attract research and development and
> advanced manufacturing to Europe.
Regarding the current lengthy approval times, the proposed reduction of EMA’s
standard assessment timelines from 210 to 180 days — as suggested in the
revision of the pharmaceutical legislation — would allow regulators to
accelerate their scientific assessments. Furthermore, the European Commission
can streamline its decision phase (currently requiring up to 67 days) by
conducting its activities in parallel with the scientific assessment.
Strengthen the EU Medicines Regulatory Network and embrace regulatory sandboxes
Achieving greater speed and agility within a regulatory system requires an
appropriately resourced, sustainable regulatory infrastructure. We support
transparent regulatory budgets across the network, backed by consistent
investments in expertise, funding and infrastructure to support continuous
capacity and capability advancements. Collaborative regulatory pathways (such as
the EMA OPEN framework) could be further expanded to encourage simultaneous
approvals and supply chain resilience across geographies.
Additionally, regulatory sandboxes would be beneficial to pilot and adapt
frameworks for disruptive future innovations, while ensuring appropriate
guardrails to enable the safe development and implementation of these
innovations.
Enhance patient engagement
Effective regulatory decision-making requires both inclusivity and adaptability.
Limited patient and expert input can hinder effective regulatory
decision-making, while rapid pharmaceutical innovation requires adaptable
frameworks. Expert and patient perspectives are crucial for informed
benefit-risk and clinical meaningfulness determinations.
Disclaimer
POLITICAL ADVERTISEMENT
* The sponsor is Eli Lilly & Company
* The advertisement is linked to General Pharmaceutical Legislation (GPL), In
Vitro Diagnostic Regulation (IVDR), Critical Medicines Act (CMA), Biotech Act
(Part 1), Clinical Trials Regulation (CTR), EU Medicines Regulatory Network
More information here.
--------------------------------------------------------------------------------
[1] IQVIA, Assessing the clinical trial ecosystem in Europe, Final Report,
October 2024: efpia_ve_iqvia_assessing-the-clinical-trial-ct-ecosystem.pdf.
[2] Lara J, Kermad A, Bujar M, McAuslane N. 2025. R&D Briefing 101: New drug
approvals in six major authorities 2015-2024: Trends in an evolving regulatory
landscape. Centre for Innovation in Regulatory Science. London,
UK: https://cirsci.org/wp-content/uploads/dlm_uploads/2025/08/CIRS-RD-Briefing-101-v1.1.pdf.
[3] The Patients W.A.I.T. Indicator 2024 Survey.
https://www.efpia.eu/media/oeganukm/efpia-patients-wait-indicator-2024-final-110425.pdf