Shifting towards needs-driven healthcare: highlights from the Belgian high-level conference

Within the European Union, significant sums of public funding are invested to meet patient needs. This includes funding of research into innovative healthcare interventions, incentives for (pharmaceutical and other) companies to develop products addressing unmet needs (through direct financing, subsidy or regulatory mechanisms), public procurement, and reimbursement.

Decisions on the authorisation and reimbursement of healthcare interventions are often supply-driven, initiated by a developer, rather than based on previously defined, evidence-based priorities for patient and societal needs. To ensure optimal use of public funding, it is imperative to define needs independently of the interventions/products in the pipeline. Identifying where needs remain high is paramount. Unmet patient needs may be due to, for example, decreased life expectancy or quality of life impairment. Societal needs may relate, for example, to the need to allow people to return to work more quickly or the need for affordable preventive treatments for (contagious) conditions.

The EU has a pivotal role in shaping these mechanisms through its substantial research funding programs, as well as through awarding regulatory incentives. This two-day conference provided a platform to discuss how health-related needs can shape the future of needs-driven healthcare systems. Over 250 participants attended the conference, including representatives from Member States, the EU institutions and other international organisations, patient organisations, and academia. They engaged in 
discussions ranging from smart research funding and regulatory incentives to reimbursement of health interventions targeting identified high unmet needs.

Throughout the conference, experts emphasized the crucial importance of health systems effectively tackling the most pressing needs. This requires robust evidence, a shared understanding of priority needs, coordinated public incentives, and predictability for developers regarding the inclusion of cost-effective interventions targeting high needs in the national benefit packages. Strategically combining push and pull incentives can significantly influence decisions in research and development, thereby impacting the eventual innovation that reaches the patient.

Looking ahead, experts reflected on the achievements within the field of health-related needs, while also considering the challenges for the future. One of the main takeaways was the need to set up an adequately financed, independent research infrastructure at the EU level. This could support research on unmet needs across various health conditions and generate an evidence database. This strategy also recognises that the identified needs may be addressed through different types of health interventions. Additionally, participants agreed that a Member State-driven mechanism is needed to assess and prioritise health-related needs, based on scientific evidence and using transparent assessment criteria. Subsequently, a strategic plan developed at EU level should provide an effective response to the identified pressing needs, coordinating and directing public support and regulatory incentives.

Ultimately, the conference has been a new step towards more needs-driven decision-making, both at the EU and Member State level. 

More information can be found in the KCE Report on Needs which was published on 28 March 2024. 

Contact details
Federal Agency for Medicines and Health Products (FAMHP): comm@fagg-afmps.be
National Institute for Health and Disability Insurance (NIHDI): communication@riziv-inami.fgov.be 
Health Care Knowledge Centre (KCE):  info@kce.fgov.be