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— Don’t shy away from regulating food, alcohol and tobacco to tackle Europe’s biggest threat to society — chronic diseases — says the head of Austria’s food and drugs agency.
— An expert panel in Germany hands down a proposal to reward pharmaceutical companies that invest in Germany through clinical trials or manufacturing.
— One MEP remains unconvinced on a critical patent proposal on the table for the Biotech Act following a roundtable of industry and European officials.
Welcome to Wednesday’s Morning Health Care! Seven coffees, two schnitzels, two paninis, a lemon tart and a heaping of scrambled eggs later, and that’s a wrap on our first 24 hours in Gastein. Another week like this and Claudia and I might need to take a closer look at the Commission’s heart health screening recommendations we’ve written so much about after we get back to Brussels …
Get in touch: [email protected], [email protected]. Follow us on X: @chiappa_claudia,@domgiannini_
RAMPING UP PREVENTION: Governments should focus on regulating key unhealthy ingredients instead of getting caught up in the “complex” debate on ultra-processed foods, according to Johannes Pleiner-Duxneuner, managing director of the Austrian Agency for Health and Food Safety.
Prevention: Preventing growing rates of chronic diseases is one of the main areas governments should focus on “because non-communicable diseases, diabetes, obesity are the main threats for our society,” he told Morning Health Care on the sidelines of the European Health Forum in Gastein, Austria.
But but but: discussions on prevention can get complicated, he said, for example when trying to tackle ultra-processed foods. The key is to keep it simple, Pleiner-Duxneuner said. “We should focus on sugar, salt, alcohol, tobacco. I think these are the main killers.”
Zooming out: Brussels is currently a hotspot for the prevention debate, with discussions on how to tackle ill health caused by industries such as food, alcohol and tobacco often heating up. Earlier this week, MEPs clashed over language describing the impact of alcohol on cancer in a parliamentary cancer report. Some lawmakers argued industry profits were being put before people’s health.
But it’s not just alcohol: Lawmakers are struggling to figure out how to nail down the best measures to reduce consumption of ultra-processed foods and tobacco. The debate on UPFs is gaining momentum, with the European Commission recently asking its Scientific Advice Mechanism to assess how UPFs should be defined, their health effects and consumption patterns. And tobacco regulation continues to divide countries as the EU mulls a proposal to raise taxes on cigarettes and set minimum levies for vapes, heated tobacco and nicotine pouches.
The sugar debate: More countries are introducing sugary drink taxes in an attempt to curb consumption amid soaring obesity rates, particularly among children. The measures are backed by the World Health Organization, which says “… taxes are one of the strongest tools we have for promoting health and preventing disease.” The German government is planning to introduce a new tax on sugary drinks starting in 2027, while the U.K., for example, has had one for years. Pleiner-Duxneuner said he’s a “fan” of the U.K.’s sugar tax: “From a scientific clinical point of view, there is no reason not to implement it in other European countries.”
Tricky: Though Austria does not currently have a sugar tax, the topic often enters the public and political debate — though it receives pushback from industry, Pleiner-Duxneuner said. “Definitely no one wants to damage the industry, so that’s one of the reasons why it’s not a hot topic at the moment,” he said. “But I think it is one of the tools that you can [use] to reduce sugar consumption.”
Don’t forget education: It’s key to pair regulation with educational programs targeting children, starting as early as kindergarten. “Austrian figures show that it’s seven times more effective if you do education in kindergarten or early school pupils rather than doing it with teenagers,” he said. And it’s key to meet children where they are: social media. “This is something we’re looking at — advertisements also on social media, not only TV commercials.”
WHO’S GOING TO COUGH UP FOR THE BONUS? A proposal to reward pharmaceutical companies that invest in Germany, through clinical trials or manufacturing, has left the hardest question unanswered — how to pay for the industry incentives, our colleague Louis Westendarp writes in.
An expert panel handed over its plan on Tuesday to two state secretaries — one from the German Ministry of Economic Affairs and one from the Ministry of Health. The government promised to deliver the proposal by the end of the month, after concluding sweeping health care reforms in July, including cutting drug prices by more than doubling mandated discounts.
At the same time: Germany is under U.S. pressure to increase its drug prices, and many are watching to see if this proposal will also appease Trump administration officials. Closed-door talks between the two countries are ongoing.
Will it be enough? As our Berlin colleagues reported at the start of the month, the offer is to phase out the scheduled 8.5 percentage points increase in the manufacturer discount from 7 percent to 15.5 percent — with a 2 percentage point cut for adhering to collective bargaining agreements, 3 percentage points for local research and development, and 3.5 for German production.
The cost: The scheme costs approximately €1.3 billion, according to the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband). However, it remains unclear who will cover this expense. The report merely outlined several financing options, also scooped by our Berlin colleagues.
Proposal 1: Pharmaceutical companies that do not meet the bonus criteria should bear the cost of the scheme through a higher price discount. However, the expert panel deemed this proposal “ineffective,” according to the report.
Proposal 2: Funds for the bonus could be saved elsewhere within the statutory health insurance system. This would require a further review of the finance commission’s report.
Proposals 3 and 4: The regulation could pay for itself through macroeconomic effects, or the bonus could be funded via the federal budget.
No decision reached: The matter has been left for others to decide — specifically, the coalition parties, people close to the panel told Louis. “We will now examine it in greater detail and proceed to implementation as quickly as possible,” Frank Wetzel, State Secretary at the economic affairs ministry, said.
Ahem: It’s not the only tricky financial issue Germany is trying to resolve right now, with long-term care, pensions, and the fuel tax rebate also up for debate.
BAND OF BROTHERS: Back at Gastein, Pleiner-Duxneuner revealed that Austria is working on a reimbursement model with Belgium, the Netherlands and other countries with similar pricing systems, as pharma companies were becoming increasingly willing to walk away from talks. Companies were instead opting to maintain higher prices in the U.S. to avoid Trump policies that copy lower prices in Europe, said Pleiner-Duxneuner.
Changing track: “In the past years, the companies were fighting actually to get access in Austria, and what we see more and more is that actually they’re leaving the table: ‘No, we are not launching it with that price … otherwise we would have an average price that is ruining also the U.S. market price’,” Pleiner-Duxneuner told Morning Health Care. This has already happened for a handful of medicines including those for orphan diseases and cancer, he said.
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STAYING PUT: A roundtable of industry and European officials to thrash out the pros and cons of extending patents for certain biotech drugs failed to convince one of the MEPs critical of the proposal in the Biotech Act to change his mind.
What’s this about? Leading MEPs on the law hosted the meeting Tuesday to address concerns from some lawmakers that no independent impact assessment had been conducted on the bill. The proposed patent extension — known as a supplementary protection certificate — is one of the main sticking points in negotiations between MEPs. The one-year extension is designed to entice drug developers to test and manufacture in Europe.
No thanks: Socialists and Democrats MEP Tiemo Wölken — who is leading the legal affairs committee opinion on the law — said he didn’t hear anything to change his mind on granting patent extensions. “The Union cannot afford to grant additional patent protection without securing tangible benefits in return,” he told Morning Health Care. His amendments have sought to remove the patent offering.
Conditional: Some in industry have lobbied to remove the clinical trial and manufacturing conditions for the patent. “Multi-country clinical trials and the significant production within the Union are the only real added value in the Commission’s proposal, and we must safeguard them,” Wölken said. “Anyone seeking to weaken or remove these criteria is working against the Union’s interests.” He said it would have been good to hear from patient groups about the impacts as well.
They agree: Several NGOs expressed disappointment to Morning Health Care that they weren’t invited, arguing the panel was too industry-heavy. “We are particularly surprised and concerned that civil society representatives, especially patient representatives, were not invited to this meeting,” the European Patients’ Forum said. “Patients and their representatives have an essential role to play in this debate. We also have important perspectives to contribute on the Biotech Act and the extension of Supplementary Protection Certificates (SPCs), particularly as patients will be directly affected by its consequences.”
Patients first: The European Patients’ Forum wants to scrap the patent extension proposal, “because of its impact on timely patient access to medicines and the sustainability of healthcare systems,” it said. The EPF also doesn’t want clinical trial timelines to be further reduced so that patients’ rights and safety remain the priority.
Moving too fast: The forum also raised concerns about the pace of negotiations, as MEPs are trying to agree on a compromise text by December. “This is particularly important given the exceptionally fast pace of negotiations, which raises concerns that key issues may not receive the in-depth consideration they require, particularly in a broader political context where competitiveness is increasingly being prioritised over public health objectives,” EPF added. You can see all their asks here.
INCREASED SPREAD: Climate change is spurring the spread of diseases like dengue and chikungunya through vectors such as mosquitoes, ticks, and bugs as temperatures warm and new places become at risk, delegates at Gastein were warned Tuesday.
Speedy: One mosquito in Europe moves 60 kilometers farther north each year, and outbreaks and local transmission of dengue and chikungunya are moving even faster, reaching up to 120 kilometers farther north than before, said Jan Semenza, an environmental epidemiologist at Heidelberg University. This is putting tens of millions more people at risk every year, he said.
You can’t say we didn’t know: The world might have been caught off guard by the coronavirus and the ongoing outbreak of the Bundibugyo ebolavirus in the Congo, but it can see the rise of vector-borne diseases, HERA Deputy Head Laurent Muschel told a panel at the European Health Forum in Gastein. This was growing “slowly but surely,” which means Europe shouldn’t be caught out, he said. “We have a bit of time, but not so much, and it’s time to invest.”
Underprepared: Gaps in the European system included a lack of medical contingencies for most vector-borne diseases, including insufficient antivirals and vaccines that cover a broad spectrum, Muschel said. Diagnostics also needed to improve, he added.
A 1-year-old baby has been euthanized in the Netherlands, the Telegraph reports.
Novo to pay up to $2.6 billion for the rights to an experimental weight loss pill, reports Reuters.
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