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Do new medicines really work better than existing ones? And what is our willingness to pay for those new medicines? In his inaugural lecture, Professor Wim Goettsch calls for a critical review of medicine costs and more focus on the actual need for new medicines.

During his inaugural lecture today at Utrecht University, Professor Wim Goettsch urges for a more critical assessment of new medicines and their costs. As a Professor of Health Technology Assessment (HTA) of Pharmaceuticals, he emphasizes the importance of questioning whether new medicines offer real improvements over existing treatments.

Is it worth the money?

Goettsch specifically urges for a more critical assessment of medicines that are granted market authorisation through special processes, intended to accelerate the access to promising treatments. These medicines may receive faster European market authorisation because of urgent unmet medical needs and may have less complete evidence packages to support their effectiveness.

“This may help patients to receive new treatments sooner”, says Goettsch. “But many of these medicines may not have sufficient proof that they are actually better than existing ones.”

Many cancer drugs that were allowed to the European market through a faster process, have little or no proven extra benefit

Some of his research has demonstrated that many cancer medicines approved in Europe had no or little proof of added benefit. He indicated that this might also be true for other expensive treatments, such as those for rare diseases..

Real-life results

Goettsch also stresses the need of monitoring the performance of medicines in the ‘real world’, outside of clinical trials. “In real life, medicines may not work as well as they do in trials because they are for instance used by a wider variety of patients”, says Goettsch. “To provide patients with the best care, more data should be collected on how medicines work in the real world.”

Focus on actual needs

Goettsch emphasizes that we should encourage health technology developers to create medicines that we genuinely need. For example, many cancer medicines are coming onto the market, while other major health problems, such as mental disorders and cardiovascular diseases, seem to receive less attention.

Fewer medicines are being developed for mental illnesses and cardiovascular diseases, even though these illnesses put a significant burden on society

Goettsch estimates that nearly half of the medicines coming onto the market are for cancer treatment. “In contrast, fewer medicines are being developed for mental illnesses. Also in more recent years, the development of medicines for cardiovascular diseases seems to be relatively limited, although both mental and cardiovascular diseases put a significant burden on society. We strongly support the development of new cures for cancer, and we should continue to do so. But the question is whether we currently find the right balance between prioritizing certain disease areas and the actual health needs in our society.”

Deciding what to develop next

As a society, we may need set clearer priorities for medicine development, says Goettsch. “We are currently involved in the creation of a new scientific process that may support the identification of the greatest health needs. As a society, we may subsequently steer the development of medicines in the direction of the greatest health needs. This could be accomplished, for example, by providing targeted national and international funding for scientific research. Another approach could be to prioritize the market authorisation and reimbursement of medicines for which there is a high societal demand and currently have few available treatment options.”

Working together

Goettsch welcomes a new European Regulation in which European countries will collaborate on evaluating the added value of new medicines, starting with cancer treatments and medicines for rare diseases.

By joining forces, EU countries can make fairer choices about which medicines to fund

This collaboration aims to get a better insight on which new treatments actually provide an improvement compared to the current standard practice. “By joining forces, EU countries may finally come to more aligned and fairer choices about which medicines provide an additional value to patients and societies,” he says.

Other positions

Besides his position at Utrecht University, Goettsch advises on health technology assessment (HTA) at the . His professorship is part of an academic research network on HTA between the National Health Care Institute, Erasmus University Rotterdam, and Utrecht University, which aims to improve aligning HTA research and policy.