Access to healthcare: EU health inequalities persist

The COVID-19 crisis has highlighted the inequalities in our healthcare systems; we should prioritise these, not pharma profits, writes Michèle Rivasi.
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By Michèle Rivasi

Michèle Rivasi (FR, Greens/EFA) is a member of Parliament’s Special Committee on Beating Cancer

02 Jun 2021

When it comes to equity and access to healthcare, the EU could do better. Inequalities around diagnosis and access to drugs and treatments persist; European citizens are not all benefiting equally from universal healthcare services. In addition to these inequalities, one can add another: the discrepancy in detection and diagnosis according to one’s country of residence. Thus, cancer survival rates are often worse for patients in eastern Europe than those being treated in western Europe.

Member States do not have the same management tools at their disposal because they do not benefit from the same investment capacities. Rather than making sustainable investment in community-based services and facilities and re-establishing equality of access to treatment and the early detection of diseases, the European Commission is moving to a ‘Europe of digital health’ model, relying on ‘virtual’ consultations, based on a telemedicine or telesurgery approach.

“The pharma industry emerges the winner in this misguided system, but what are the benefits for European public health?”

Furthermore, between 2000 and 2008, shortages of medicines increased by 20 percent, and - according to the European Commission in April 2020 - these were continuing to increase. In France, for example, supply interruption has trebled in just three years. More than half of the medicines in short supply are for cancers, infectious diseases and neurological disorders such as epilepsy and Parkinson’s disease. How can we explain these shortages? The relocation of production sites, particularly of active ingredients, to countries outside Europe, has weakened our healthcare sovereignty.

Among the solutions undertaken by the EU, it is essential that the wholesalers provide a reliable, controlled distribution chain for pharmaceutical products to the pharmacies. However, we have seen an increase in alternative and direct channels of distribution between the pharmaceutical industry and pharmacies.

Parallel trade, originally authorised by the WTO to allow treatments to be purchased at more affordable prices and restricted in Europe to the frontiers of the common market, has been corrupted. Under these conditions, big pharma is reinforcing its profits and growing its influence over the entire healthcare system. The EU must take back power by investing throughout the entirety of manufacturing operations by, for example, implementing European pharmaceutical establishments with a non-profit making objective, such as we in the Greens/EFA group have been proposing. In less than ten years, the pharmaceutical industry has moved from a mass market to a niche one, innovating at high added value.

The fight against cancer has become a pretext for numerous new therapies, the most common being biological medicines. In so doing, the drug companies are replacing access to treatment for all with innovative drugs accessible only to some. These biologicals, which the Commission wishes to sustain, will doubtlessly be highly lucrative for their manufacturers.

The sharp rise in the price of these new drugs is making them difficult for communities to afford, and is driving up the cost of health insurance while reinforcing a two-speed Europe, divided between the richest and poorest. The pharma industry emerges the winner in this misguided system, but what are the benefits for European public health?

Today, such inequalities are to be found at the heart of the current healthcare crisis. France, for example, is fully reimbursing PCR tests for COVID-19. However, when immunity tests will perhaps be available, who will pay for them, citizens, Member States or the European Union? Plans to introduce digital healthcare certificates must not reinforce these inequalities or create new forms of discrimination.