Using evidence-based management in practice: a case study on the pricing and reimbursements of medicines

In the last twenty-five years, there were several initiatives for European Member State (MS) collaboration for pricing and reimbursement. Initially, these were driven by the MSs, were voluntary, lacked coordination between them, and were not systematic (World Health Organisation [WHO] 2015). Council Conclusions of different Presidencies of the Council of the European Union supported MS-driven voluntary cooperation on health technology assessment (HTA) (Council of the European Union, 2016; Council of the European Union, 2017). Pricing and reimbursement authorities of most MSs collaborated within the ‘European Network for Health Technology Assessment’ (EUnetHTA) (EUnetHTA, 2018); however, difficulties were experienced with implementation (European Commission, 2016). In 2018, the European Commission came up with a legislative proposal: ‘Proposal for a Regulation of the European Parliament and of the Council on health technology assessment and amending Directive 2011/24/ EU’ (European Commission, 2018). In parallel, initiatives for the development of ‘regional cooperations’ within groups of MSs had started, and Malta was signatory of the Valletta Declaration.