Speed up EU health security prep, says NATO chief medic

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By DOMINIC GIANNINI

with CLAUDIA CHIAPPA

PRESENTED BY

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— Health security dominated the penultimate day at the European Health Forum Gastein, with calls for Europe to be better prepared to protect health infrastructure. 

— Parliament’s environment committee backs an opinion on the Biotech Act supporting a one-year patent extension. 

— Europe’s response to the U.S. most-favored-nation policy was a hot topic at Gastein, with France’s new pharma deal stealing the spotlight.

Welcome to Friday’s Morning Health Care! It’s been a big week at Gastein and it only cost attendees a bout of food poisoning, burnout and one unlucky Italian getting lost in the woods, spending the night by a waterfall before being rescued by helicopter. This year also bids farewell to Clemens Martin Auer, who hands over the Gastein presidency to Nick Fahy, director of the health and care research group at RAND Europe.

Mark your calendars: Our weekly health care calendar lands in your inbox on Thursday. You can also go online to export and plan your week or suggest your own event. 

Get in touch: cchiappa@politico.eu, dgiannini@politico.eu. Follow us on X: @chiappa_claudia, @domgiannini_  

GEAR UP: Europe needs to better prepare to protect health infrastructure, delegates heard, as health security dominated the penultimate day at the European Health Forum Gastein.

Spread out: Petter Iversen, chair of NATO’s Committee of the Chiefs of Military Medical Services, said there were different ways Europe could protect health infrastructure, which continues to be under attack in Ukraine. “You can spread things out, use a larger geographical area and hide things,” he told Morning Health Care on the sidelines of the conference.

Hiding hospitals: One option is to move hospitals into underground facilities to protect them from attacks, he said. “When we are building infrastructures in the future … we might have to think about dual use. If you’re building a parking cellar, maybe you should have enough power or electricity, and also water supplies, so you can actually build a kind of hospital in there.”

Eastern Europe is already experiencing increasing threats from Russia, with drones and cyberattacks now frequent events, Iversen said. Countries closer to Russia had good plans in place, he said. “Situational awareness is sharper closer to the eastern flank,” he said. “You feel the pressure on a daily basis.” 

Where we’re vulnerable: European pharmaceuticals and production are also at risk since supply chains are dependent on countries like China, he said. “We need to prepare to reduce our dependencies from whom we will not want to be dependent upon if it comes to a major crisis.” 

Prepare for everything: The health care system needed to be resilient enough to withstand shocks, including those that went beyond war, like earthquakes, summer heatwaves or cyberattacks putting stress on the sector, said Jarno Habicht, the World Health Organization’s outgoing representative in Ukraine. “You might have more patients, but you might be also without electricity, so we need to be ready for the shocks,” he told Morning Health Care. 

Read more about what Iversen and Habicht said on health security and Ukraine here.

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INFORMAL MEETING: Health ministers met in Dublin on Thursday where they discussed tobacco and nicotine pouches, the Biotech Act, medical devices reform and cardiovascular health.

On tobacco: Health Commissioner Olivér Várhelyi said the Commission remained committed to publishing a comprehensive review of tobacco legislation, including on advertising rules, this year and that there will be a focus on nicotine addiction.  “We are very well advanced in the preparation of the proposals,” he said in a press conference following Thursday’s meeting. 

We’re close: Forthcoming legislation would address vapes and heated tobacco products; their use being twice as high among young people than the broader population, Várhelyi said. It is important the tobacco products directive is revised to address nicotine addiction “so that we can deal with the cross-border element of this and create a genuinely harmonized system,” added Irish Health Minister Jennifer Carroll MacNeill who joined Várhelyi at the press conference. “Colleagues are concerned about the capacity of nicotine addictive companies to create new and novel ways of getting children addicted to nicotine,” she said.

Presidential priorities: The Irish presidency of the Council of the EU is pushing for the Biotech Act and Medical Devices Regulation to be finalized as the Council works on its position (more on where this is up to in the Parliament later). “This is the moment to deliver this because this is the moment when long-term decisions are made in this sector,” Várhelyi said. “But for this to succeed, we can only achieve it if we have speed, if we have simplicity and if we have predictability.”

FRENCH DEAL DOMINATES MFN TALKS: France’s new pharma agreement this week has shaken up the Gastein forum, seeping into nearly all conversations (whether on panels or by the coffee machine lines) on competitiveness, drug pricing and geopolitical relationships. Some are reeling from what they say was a very unexpected announcement, which throws into doubt what the rest of the bloc can do, while others see it as an inevitable evolution of U.S. pressure.

Recap: France announced this week a new deal with the pharmaceutical sector on drug pricing, to provide “more clarity and predictability to pharmaceutical companies.”  

Stay united: Morning Health Care reported yesterday that patients, payers, EU lawmakers and capitals urged European countries not to seek individual agreements to counter the effects of the U.S. most-favored-nation policies, urging instead for a united Europe. During a panel on Europe’s upgraded pharmaceutical legislation, speakers reiterated the message Thursday. Morning Health Care contacted the French government for comment but did not get a response.

Austria is on board: “As Europe… if we do not now see the need to act more [uniformly] and more together, I don’t know when we should see it,” said Stefan Eichwalder, director of the health systems division at the Austrian health and social affairs ministry.

It doesn’t mean not doing anything: “It would be dangerous not to act now, but then I think we need to find ways of working together,” he said. Eichwalder added that it was important that national deals — with industry or the U.S. — do “not weaken the position of the EU, and in the end, the position of any member state within the EU.” 

The bottom line: Countries should work together “no matter how difficult it is,” he said. “I don’t see a solution for Europe to go 27 different different routes.”

Think this through: Yannis Natsis, director of the European Social Insurance Platform, said countries should be asking themselves this question: If we were to accept paying higher prices, what can we get in return? “From a first reading of this agreement, France is committing to pay higher prices in return for what exactly? And what are companies committing to delivering in exchange for these higher prices?”

The bigger picture: “Many narratives are going around. Narratives that are used by different sectors to serve specific interests,” Natsis said. “And in this case, this narrative is used to ask and demand higher prices. But again, the question is: if we were to pay these higher prices in Europe… what happens to the other countries? Because if France signs an agreement, if Germany signs an agreement, what about the rest of us?”

Pushing back: Richard Bergström, vice president of European affairs at health data firm IQVIA and former chief of pharma lobby EFPIA, pushed back. “If you read the French deal… there’s a lot of wins for the governments as well,” he told panelists from the audience. “There are requirements on clinical trials, requirements on manufacturing in Europe, and most importantly, there is a gain at the end of life cycle.” It’s a “quite balanced deal,” he added.

OVER IN BRITAIN: The U.K.-U.S. drug pricing deal — which is hailed by the Trump administration and industry as a blueprint for other European countries — is running up against some challenges, our colleague Caroline Hug writes in. Four pilots rolled out to try to meet U.S. demands to double medicines spending as a percentage of GDP by 2028 are currently falling short. Britain’s new Science Minister Chris McDonald has signaled the government is willing to try new ideas.

Pilots ongoing: The government — with industry and the U.S. administration — launched the pilots running through September 2027, and the results will inform the next drug-pricing scheme.

The line: “What’s really important here is that we start with what is the objective we want to achieve, rather than the means by which we want to achieve it,” McDonald told Morning Trade U.K. during a fringe event Tuesday at the Labour Party Conference. “I don’t mind trying things, and then if they don’t work, then learning from that and moving on and trying some other things.”

New blood: McDonald replaces former Science Minister Patrick Vallance, who played a key role in the U.K.-U.S. pharma negotiations. One pharma industry figure told MTUK that McDonald “brings rare commercial instinct to the policy debate.”

Deal mode: “It was quite hard to reach an agreement across the entirety of the industry [on pilots],” said Shaun Grady, AstraZeneca U.K. chairman, pointing to varying demands of some pharma companies versus big pharmas like GSK and AstraZeneca which “invest very significantly in the U.K.” He added that conversations are “now moving much more into a bilateral phase where each company will engage with the government.”

APPROVED: Parliament’s environment committee has confirmed its position on the Biotech Act, with 53 in favor of adopting the opinion led by Nicolás Gonzalez Casares and 11 against. It supported keeping a 12-month extension of patents under certain conditions. Parliament’s legal committee also voted to keep the one-year extension in its opinion.

Coming to the table: The co-leads on the Biotech Act — Vytenis Andriukaitis (S&D) in the health committee and Wouter Beke (EPP) in the industry committee — will meet in Strasbourg next week to try and find a compromise on the patent extensions they can bring back to shadow rapporteurs.

Making progress: Andriukaitis told Morning Health Care on the sidelines of Gastein that political groups will likely have “more compromised solutions” on supplementary protection certificates, cross-border clinical trials and financing for the law by the end of October.” Read more about what he said here.

Feedback: Shadow rapporteurs on the Biotech Act on Thursday submitted their feedback to the co-rapporteurs following a roundtable between MEPs, Commission officials and industry on Tuesday. 

Remember: Some MEPs weren’t happy at being offered a roundtable in lieu of an independent assessment on the supplementary protection certificate extension (SPCs) while some NGOs were also upset they didn’t get a seat at the table. Catch up on the controversy here.

COMMITTEES BOOST PREPAREDNESS, CIVIL PROTECTION FUND: Lawmakers in the health and environment committee adopted their position on the EU’s next civil protection mechanism (UCPM), which now includes health emergency preparedness and response.

Details: The compromise text boosts the budget of the mechanism from €10 billion to €12.42 billion, earmarking 40% of the funding for civil protection, 40% for health emergencies, and 20% for flexibility. The position was approved with 61 votes in favor, nine against and nine abstentions. It will now need to be put to a vote in Parliament.

Sneaky global health reference: The adopted text includes several references to strengthening global health infrastructure. For example, it says that “strengthening cooperation … as well as the global health infrastructure and the World Health Organisation is essential to enhance the global ability to act.”

There have been four more deaths from the West Nile virus in the Netherlands, the NL Times reports.

Reuters has the details on Sanofi and Regeneron’s $8 billion partnership.

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