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Institute Report
Defining Essential Innovative Medicines and Measuring their Use in Europe
Sep 30, 2022
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Access and affordability of medicines are top priority issues for healthcare stakeholders globally. Discussions in recent years have focused on the availability and use of recently launched medicines. Among those medicines are some that can be considered “essential” on the basis that at least one similar drug in a therapeutic group has been reviewed and received public reimbursement in at least half of the European countries assessed. To date, limited evidence has been presented to show per capita use across countries and for each of the clusters or groups of these Essential Innovative Medicines (EIMs).

This report has been prepared to provide evidence and context to discussions of medicine access and use in Europe. It draws upon research undertaken at the IQVIA Institute and other parts of IQVIA and taps IQVIA’s extensive global data assets that measure the use of medicines and their costs.

Use our interactive infographic to explore average per capital Essential Innovative Medicine use in Europe across therapy clusters and countries.

Explore EIM use data

Explore EIM use data

Key findings:

Exhibit 1 (Essential Innovative Medicines Methodology)
  • From 2011–2020, 504 novel active substances (NASs) have become available to patients for the first time globally; however, these novel therapies are not always accessible to patients, with rising costs of many of these therapies leading to differences in reimbursement and affordability across countries and patient groups.
  • Issues of disparities in medicine access and pricing are a continuing area of focus for the global community, with the World Health Organization (WHO) leading discussions around fair pricing through their Fair Pricing Forums, most recently held in 2021. 
  • While significant focus has been placed on understanding pricing, understanding and describing the use of medicines across countries is important for characterizing differences in access.
Exhibit 2 (Percent of 404 global NASs (2011–2020) reimbursed by country vs. percent of 94 innovative medicine groups with at least one NAS reimbursed)
  • Of 504 NASs launched globally over the past decade, 404 have become available in Europe. 
  • There is significant variability in reimbursement status of NASs across countries, ranging from 58% of NASs being reimbursed in Germany to 4% in Portugal.
  • Reimbursement status is higher across countries when evaluating at the group level (i.e., at least one drug reimbursed within the group), ranging from 71% of groups having at least one drug reimbursed in Germany to 12% in Portugal.
Exhibit 5 (Reimbursement status for 20 analyzed Essential Innovative Medicine groups)
  • The seven clusters of EIM groups represent significant clinical advances in their disease areas and have all achieved public reimbursement for at least one drug in the group in more than half of the European countries analyzed. 
  • These countries independently assessed and arrived at reimbursement decisions, sometimes preferring one NAS over others in the EIM group, but consistently provide access to the technology in the group of innovative drugs to their populations.
  • Austria consistently imposes restricted or conditional reimbursement status compared to other countries, and yet also has among the highest per capita use of these medicines.
Exhibit 11 (Average utilization of Essential Innovative Medicines across all groups, Europe average = 100)
  • Each of the 20 EIM groups was measured in DDD per capita and compared to the European average DDD per capita indexed to 100 for the 35 European countries analyzed. 
  • The average utilization of these medicines across Europe is nearly half that in the U.S. 
  • Countries unweighted average indices show a range from a high of 236 in Luxembourg and 213 in Austria to a low of 10 in Ukraine and 16 in Bosnia.
Exhibit 20 (PD-1/PD-L1 inhibitors defined daily doses per 100k population, 2011–2021)
  • The rate of adoption of EIMs varies across the European region by EIM group. 
  • For immuno-oncology checkpoint inhibitors of PD-1/PD-L1, the most common early adopter group of countries has volume per capita almost twice the European average in 2021 and reached the current European average volume one year ahead of the common early adopter group and three years ahead of the selective early group.
  • Other countries who were not early adopters of EIMs remain at 42% of the European average volume use of PD-1/PD-L1 inhibitors as of 2021.

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Institute Report
Protection Expiry and Journey into the Market

Pharmaceutical products in Europe
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The Global Use of Medicines 2022

Outlook to 2026

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