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Country/JA: Malta flag Malta
Action type: Policy initiative

Problem: Pricing and access to medicinal products can vary widely across EU Member States and there are many challenges to effectively coordinate the negotiation and procurement of these products.

Objective: In line with the Valletta Declaration, the aim of this initiative is to establish multi-member state negotiation and procurement practices that improve citizens’ access to new and emerging medicines and lead to increased sustainability of national healthcare systems.

Implementation status: Fully implemented policy initiative and ongoing

Key Contextual Factors

  • The Valletta Declaration highlights the general aim for regional collaboration within the European Union (EU).
  • This specific initiative focuses on the following areas of cooperation: prioritisation of products for joint assessment and negotiation, sharing of information and good practices, and efforts to increase transparency for the sharing of information between Member States
  • The initiative includes the strategy-setting Ministerial Committee, which is composed of the Ministers responsible for Health (from participating MSs), and the Valletta Technical Committee (VTC), which includes technical experts from national entities.
  • Participating Member States presently include Croatia, Cyprus, Greece, Ireland, Italy, Malta, Portugal, Romania, Slovenia, Spain, which covers over 160 million citizens (31% of the EU population)

Key Components/Steps

  • The initiative started on 8 May 2017
  • Meetings are held at both Ministerial and technical levels, and since 2020 are held online
  • The technical committee is led by a designated Chair and Vice-Chair and supported by a secretariat (meetings are held on a rotational basis)
  • The technical committee prioritizes and chooses the products to be evaluated
  • Each Member State pays its own costs

Main Impacts / Added Value

  • The main outcome is the establishment of processes for coordinated and timely information sharing. It is a voluntary regional cooperation between a group of EU Member States, that is continuing to build on more than four years of experience.
  • Collaboration has led to increased cooperation and coordination between the Ministers responsible for health and also between the technical experts of the countries concerned.
  • Increased interaction leads to more informed decisions.
  • There are also initiatives where the countries within the VTC collaborate together to form a strong group to support certain policy initiatives.

Lessons Learned

  • Collaboration requires a lot of work, goodwill and trust.
  • Collaboration does not reduce the requirements of national resources, although there could be benefit from the different types of expertise available within participating countries. 
  • Countries have different priorities, national legislation and regulatory frameworks and different levels of resources and expertise, which affect their ability to collaborate and to implement national changes to increase streamlining within the collaboration.
  • It is important to maintain momentum in spite of ongoing challenges, such as frequent changes in governments and in people in key positions within relevant entities. 
  • Industry is hesitant to participate in joint negotiation and procurement activities due to concerns over setting a single price for all participating countries, negative joint outcomes/evaluation, and the business implications they face from a more transparent process.

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