US Biotech in Europe

How HTA Bodies Can Boost Your US Payer Negotiations

The rare disease landscape presents unique challenges and opportunities for pharmaceutical and biotech companies. While the US market offers a large patient population and potential for high drug prices, navigating the complex regulatory and payer landscape can be daunting. For US-based companies developing rare disease therapies, a strategic expansion into Europe can surprisingly strengthen their position in US payer negotiations. This guide explores how leveraging Health Technology Assessment (HTA) bodies in Europe can bolster your US market access strategy, and why a dual development and commercialization approach is crucial for success.

The European Advantage for Rare Disease Therapies

Europe, with its diverse healthcare systems and centralized regulatory body (the European Medicines Agency or EMA), offers a compelling alternative to the US market. Several factors make Europe an attractive option for rare disease therapies:

1. Orphan Drug Designation (ODD):

The EMA offers ODD to incentivize the development of therapies for rare diseases. This designation provides various benefits, including market exclusivity (10 years), fee reductions, and scientific advice.

2. Health Technology Assessment (HTA):

European countries rely on HTA bodies to evaluate the clinical and economic value of new therapies. Positive HTA assessments can significantly influence payer decisions and improve market access.

3. Centralized
Procedure:

The EMA’s centralized procedure allows for a single marketing authorization valid across the entire EU, streamlining the approval process and reducing time to market.

Leveraging European HTA to Strengthen US Payer Negotiations

A successful launch in Europe, particularly with positive HTA assessments, can serve as a powerful lever in US payer negotiations. Here’s how:

Evidence of Value:

Positive HTA assessments from reputable European agencies like NICE (UK), HAS (France), or IQWiG (Germany) provide robust, independent evidence of your therapy’s clinical effectiveness, safety, and cost-effectiveness. This strengthens your value proposition in US negotiations by demonstrating the therapy’s impact on patient outcomes and its value for money.

Reference Pricing

Some US payers consider international pricing and reimbursement decisions when determining their own coverage and reimbursement policies. A favorable price or reimbursement decision in Europe can create a reference point and strengthen your negotiating position in the US. Research by the USC Schaeffer Center for Health Policy and Economics found that nearly half of US commercial insurers use international reference pricing for oncology drugs.

Global Reputation

A successful European launch with positive HTA assessments can enhance your company’s global reputation and credibility, making it easier to engage with US payers and build trust in your therapy’s value. Positive media coverage and recognition from European patient advocacy groups can further amplify this effect.

Real-World Examples

Several rare disease therapies have successfully leveraged positive European HTA assessments to gain traction and expedite negotiations with US payers. These assessments provide credible, third-party validation of a therapy’s clinical and economic value, making it more difficult for payers to deny coverage or impose restrictive reimbursement policies. While specific examples remain confidential due to the sensitive nature of pricing negotiations, the trend of using European HTA as leverage in the US is increasingly common and has led to improved patient access to life-saving treatments.

The Dual Approach:
Maximizing Market Potential and Impact

While leveraging European HTA is a valuable strategy, a dual approach that considers both the US and European markets from the outset can yield even greater benefits. A study published in the Journal of Market Access & Health Policy found that rare disease therapies launched in both the US and Europe experienced a 20% increase in peak sales compared to those launched solely in the US.

By planning for a dual launch, companies can:

Optimize Clinical Trial Design

Designing clinical trials that meet both EMA and FDA requirements can streamline the approval process and avoid costly and time-consuming delays.

Accelerate Time to Market

Simultaneous submissions to both agencies can lead to faster approvals and patient access in both regions.

Maximize Revenue Potential

Reaching a larger patient population across both markets can significantly increase sales and revenue, which can be reinvested in further research and development.

Mitigate Risk

A diversified market presence can help mitigate risks associated with regulatory or reimbursement challenges in a single market.

Germany:
A Strategic Entry Point for Europe

Germany is often considered a strategic entry point for US biotech companies seeking to expand into Europe. With its large population, robust healthcare system, and well-established regulatory and HTA processes, Germany can serve as a springboard for broader European market access. Germany is also home to a significant rare disease patient population and a strong network of rare disease experts and advocacy groups.

Early Access Programs:

Germany offers early access programs that allow patients with unmet medical needs to access promising therapies before formal approval.

Favourable Reimbursement Environment:

Germany has a relatively transparent and predictable reimbursement system, with the potential for high reimbursement rates for innovative therapies.

Strong Research Infrastructure:

Germany offers early access programs that allow patients with unmet medical needs to access promising therapies before formal approval.

Rare Disease Biotech in Europe

Key Considerations:
Dual Development and Commercialization Strategy

To successfully execute a dual approach, companies should consider:

Early Engagement:

Initiate dialogue with both the EMA and US FDA early in the development process to align expectations and avoid surprises.

HTA Preparedness:

Develop a robust value dossier that aligns with European HTA requirements and demonstrates the
therapy’s value proposition.

Pricing and Reimbursement Strategy:

Craft a global pricing and reimbursement strategy that considers the unique dynamics of both the US and European markets.

European Affiliate:

Establish a presence in Europe to facilitate engagement with local stakeholders, navigate regulatory processes, and build relationships with key opinion leaders. A presence in Germany can offer significant advantages due to its robust healthcare infrastructure and favourable regulatory environment.

Partner Rare:
Your Strategic Partner for Global Success

Partner Rare brings together a unique blend of expertise to guide you through the intricacies of the rare disease landscape. Our team comprises seasoned industry leaders, including:

Experienced CEOs:

Individuals who have led successful rare disease companies, offering invaluable insights into strategic decisionmaking and operational excellence.

Government Advisors:

Experts with in-depth knowledge of regulatory frameworks and policy landscapes, ensuring your approach aligns with current requirements.

World-Renowned Professors in Translational Science:

Scientific leaders with a proven track record of translating research into innovative therapies, providing cutting-edge knowledge and guidance.

Life Science Legal Experts:

Legal professionals specializing in the life sciences sector, with extensive experience in European regulations, particularly in Germany, safeguarding your interests, and ensuring compliance throughout the process. This expertise includes establishing European affiliates and navigating the intricacies of the German legal and banking systems.

Entrepreneurs at the Forefront of Drug Repurposing:

Visionaries who identify and champion innovative approaches to repurposing existing medications for rare diseases, accelerating the development of new treatment options.

Keynote Speakers and Patient Advocacy Specialists:

Influential voices who drive awareness, shape policy discussions, and advocate for the needs of patients and families affected by rare diseases.

Conclusion

In the complex world of rare disease therapies, a strategic expansion into Europe and leveraging HTA assessments can significantly bolster a US biotech company’s position in negotiations with US payers. By adopting a dual development and commercialization approach and proactively engaging with European stakeholders, companies can maximize the market potential of their therapies, accelerate patient access, and ultimately improve outcomes for those living with rare diseases.

Partner Rare is uniquely positioned to guide you through this journey, offering a comprehensive suite of services and a deep understanding of the European landscape. With our support, you can confidently navigate the complexities of global market access and ensure your rare disease therapy reaches the patients who need it most.

If you are ready to unlock the vast potential of Europe for your rare disease therapy, contact Partner Rare today to schedule a meeting.

Let’s discuss your specific development and commercialization goals and explore how our expertise can propel your therapy towards success.

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