Topics Regular meeting with the German Association of the Research-based Pharmaceutical Industry (vfa)" was held

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The JPMA International Affairs Committee's European & American Subcommittee holds annual meetings with the European Federation of Pharmaceutical Industries and Associations (EFPIA), the Association of the British Pharmaceutical Industry (ABPI), the French Association of the Pharmaceutical Industry (Leem), and the German R&D-based Pharmaceutical Industry Association (vfa) as part of its activities to resolve international issues in cooperation with European and American governments and pharmaceutical organizations. The meeting is held every year. The regular meeting with vfa was held on November 24, 2022, in a hybrid face-to-face and online format, with approximately 30 participants from both sides engaged in a lively exchange of ideas. A summary of the meeting is provided below.

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Introduction

The meeting started with opening remarks by Mr. Harald Zimmer, Senior Manager of International Affairs at vfa. He expressed his pleasure at the fact that the meeting was the first face-to-face meeting in three years, and his hope that the discussion would deepen the knowledge of the participants.

In the session that followed, vfa gave a presentation on the General situation of the Central Federation of Public Health Insurance's Financial Stability Law (GKV-FinStG) and on the Health Technology Assessment (HTA).

JPMA presented an overview of the Framework Policy announced in 2022, its impact on the industry, and JPMA's efforts in preparation for the G7 Hiroshima Summit 2023.

In addition to each session, a Q&A session was held under the theme of Pricing & Reimbursement, where both vfa and JPMA exchanged opinions on the respective topics.

Recent development of the coalition government in Germany, GKV-FinStG

Manager Health Policy, vfa Sven Prietzel

In this session, vfa introduced the details of the GKV-FinStG, which was approved in November 2022, and expressed strong concerns about the regression of the access environment to medicines in Germany, including the shortening of the free pricing period for new drugs and the reduction of prices for drugs used in combination therapy.

During the question-and-answer session, he mentioned the difficulties in the future outlook for discount rates and other factors stipulated in the GKV-FinStG, as well as the fact that Germany, like Japan, has an aging population, and the growing GKV*1 deficit that has accompanied this aging population has influenced the passage of the GKV-FinStG. He also explained the contradictory situation in the European Union (EU), where high drug prices have become a problem from a financial point of view, in relation to regulations that conflict with the policy of improving access to rare disease medicines. He also recognized that the country is now facing a variety of challenges accumulated since the previous administration.

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    GKV: Public health insurance operated by the disease bank

Pricing & Reimbursement

This session was followed by a discussion on the German drug pricing and reimbursement system. The JPMA asked questions about the current status of drug transactions at pharmacies and wholesalers, and the impact of global inflation and energy price hikes on the stable supply of medicines, which were answered by the vfa. The vfa also recognized the need to closely monitor how the tightening of regulations on drug prices and insurance reimbursement in Germany would affect access to medicines.

Current status over the NHI drug pricing system in Japan

Yoshitaka Kusakai, Chairperson, JPMA Industrial Policy Committee

This session included an introduction to the current situation regarding the NHI drug pricing system in Japan, where NHI prices have been reduced for five consecutive years since 2018, indicating a continuing drug lag or drug loss for new drugs and a declining competitiveness of the Japanese market. Countermeasures to address these issues included a review of the NHI drug price system, drug regulations, and solutions related to the clinical research environment. He also introduced the pharmaceutical industry's expectations for the Ministry of Health, Labour and Welfare's newly established expert panel as an opportunity to discuss these issues in a comprehensive manner.

During the Q&A session, vfa asked questions about the Japanese government's support measures for pharmaceutical supply issues and where the responsibility for stable supply lies, and JPMA responded.

G7 Summit Hiroshima in 2023

Chairperson, JPMA International Affairs Committee, Mr. Tatsuya Ito

During this session, the Health Agenda for the G7 Hiroshima Summit 2023, to be held in May 2023, was introduced. The proposal was prepared in the form of a joint proposal by the JPMA and the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), and stated the need for more equitable and sustainable health systems and sustainable investment in innovation to create the infrastructure to support them in the midst of a global pandemic.

Germany was the previous host of the G7, and JPMA expressed its deep appreciation for vfa's support to date for hosting the meeting in Japan, and reaffirmed its commitment to continue to work closely together.

Health Technology Assessment

Senior Market Access Manager, vfa Mr. Sebastian Werner

In this session, the background of the legislation, basic information, and the German position on the European HTA, which will start to apply to some medicines in 2025, were explained from the perspective of a practitioner who was actually involved in the HTA at the German Institute for Quality and Efficiency in Medicine (IQWiG).

The regulation has three major goals: (1) to improve the availability of innovative medical technologies to European patients, (2) to ensure efficient use of resources and enhance the quality of HTA across Europe, and (3) to improve business predictability. However, concerns were expressed that the published guidance for the European Network for Health Technology Assessment (EUnetHTA) 21 is far from its original purpose, creating an unprecedented duplication of effort, and that the voices of industry continue to be ignored in the guidance. In particular, access to the Joint Scientific Consultations (JSC) is restricted and potentially denied, which was described as a fatal error.

Concluding Remarks

Mr. Zimmer of vfa thanked the JPMA for hosting this meeting, which was an informative discussion, and noted that he was impressed with the JPMA's efforts to address issues related to Japan's Framework Policy and the pharmaceutical market, and that intensive follow-up is needed in the future. Nobuo Murakami, Vice Chairperson of the JPMA's International Affairs Committee, stated that while Japan and Germany are facing difficult situations with each other, they would like to make a balanced proposal in order to maintain a sustainable healthcare system, industry growth, and patient access to medicines. He also mentioned the usefulness and importance of face-to-face discussions, and stressed that both vfa and JPMA would like to maintain their relationship and continue discussions in the future.

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( Takashi Hisamura, Team Leader, Germany Team, Europe Group, International Affairs Committee, Europe and North America Subcommittee)

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