No negotiations have been concluded between the Valletta group and Pharmaceutical companies because drugmakers have pulled out “as soon as we seemed to be getting somewhere”, Minister for Health Chris Fearne said in an interview with Politico.

The group of ten countries participating in the Valletta Declaration – an initiative to jointly negotiate drugs prices with pharmaceutical companies – is made up of an alliance between Malta, Portugal, Spain, Italy, Cyprus, Greece, Slovenia, Croatia, Romania and Ireland.

Speaking with Politico, Fearne said that he will be hosting the other nine countries in the Maltese capital Thursday and Friday to take stock of the cooperation and discuss how to take it forward.

The main goal of the talks will be to convince his counterparts, mostly from Southern Europe, to agree to drop the confidentiality clauses that countries sign in deals with pharmaceutical companies.

“I think that if we can go to the industry as a group and say that it’s no longer acceptable to have this secrecy on any negotiating procedure, then the industry will have to take notice.”

The Health Minister, however, said that they could incentivize talks with manufacturers on new antibiotics, which are badly needed in the fight against antimicrobial resistance.

When asked what the Valletta cooperation has achieved in the two years since it started, Fearne first pointed out that the way that the pharmaceutical industry has sold itself to authorities is that they tell everyone they’re giving us the best price.

“it’s impossible that they give everyone the best price – but many of us believe that we are getting the best price. So there’s been a lot of reluctance to start cooperating.”

“Because we all think that if we reveal or if we stop negotiating individually… the price will go up rather than go down. This is nonsense.”

Looking back on the last two years, he maintained that they have been important due to the trust that has been built between the Valletta declaration members – and now they can “go into doing something concrete”.

He did admit that one of the challenges has been, more or less, negotiating with the pharmaceutical industry on a voluntary basis with the expectation that the price will go down.

“But of course the industry doesn’t have anything pushing them, so as soon as we seem to be getting somewhere, they pull out because [it isn’t] in their interest for the price to come down.”

He noted that the World Health Assembly had voted on a resolution piloted by Italy a few weeks ago which called for transparency of net pricing, which Italy will be presenting at the meetings.

“Whenever there are contracts signed, one of the clauses is that there is a non-disclosure agreement on the price. I believe we have to discuss whether this can go on, or if we should stop it.”

With regards to agreements that are already in place, the Health Minister explained that there are the legal constraints and they are obviously not advocating breaking any laws or any contracts.

 

Antimicrobial Resistance

Fearn then went on to explain that a discussion on antimicrobial resistance is also planned as “AMR is one of the biggest health risks that we are facing and governments need to intervene”.

“[Given] that we have to collaborate with industry when it comes to research and the sharing of risk, then it will only make sense that those of us who share the risks will share the benefit when eventually new drugs or new antibiotics are developed.”

He explained that the model that they will be proposing, which is all up for discussion, is that member states which are providing funds should aim to go into an agreement with the industry to share the benefits when there are new drugs on the market.

“The industry wants and needs support from member states because it’s evident that industry on its own is not going in for the risk of developing new antibiotics.”

He clarified that there are various options as to how this model would work in practice, one of which would be sharing the risk by putting in the funds and then pushing the research, and then once drugs come on the market they would have preferential pricing for those countries that would be almost like shareholders in the project.

“There’s a lot of European legislation that we need to look at, like state aid, but there’s a market failure here, so there are ways around it.”

When asked why the focus is on research when the industry says the problem is the market for antibiotics, Fearne said that when they discuss with the industry regarding [joint negotiations on drug] prices, it has not been in their interest to find agreement because it would bring the pricing down.

“[Finding new incentives for antibiotics research] is actually in our interest as member states and as patients and [also] in the industry’s interest – so this is a win-win situation which allows us to go forward.”