The Opinion on innovative payment models for high-cost innovative medicines analyses how national pricing and reimbursement authorities could improve patients’ access to innovative medicines and foster innovation that matters whilst ensuring that health systems are financially sustainable. It explores feasible new ways of setting prices for specialty medicines in terms of improving access. While stressing the unlikelihood that a single payment model would be optimal for all situations, the Opinion sets out some broad principles to guide the definition of specific payment models. These include greater price and cost transparency, looking at patent law and market exclusivity rules to promote and reward high-value innovations, and developing and using methods to measure the social value of pharmaceutical products, e.g. in the context of Health Technology Assessment (HTA).

The Opinion on benchmarking access to healthcare in the EU responds to the request for quantitative and qualitative benchmarks to assess progress in reducing unmet need for healthcare. It can support Member States in bridging the gaps in access to healthcare, giving effect to the principle of access to healthcare enshrined in the European Pillar of Social Rights (November 2017). The Opinion is based on the data collected through the EU annual Survey of Income and Living Conditions (EU-SILC), drawing attention to evidence of relatively high rates of unmet healthcare needs in some EU countries. The Panel proposes a mechanism for setting an ambitious but achievable target for unmet needs based on the median achievements of the best performing Member States. The Panel also advises on how to identify the distribution of unmet needs and how to address challenges by mobilising resources available at national and European level.

The Opinion on tools and methodologies for assessing the performance of primary care explores how to measure the performance of primary care. It takes account of the complex structure, modes of operating and services provision of primary care, and also of its outcomes, particularly in terms of relevance, equity, quality and financial sustainability. The Opinion translates multiple dimensions into comparative key indicators, and descriptive additional indicators, related to the 10 identified domains of primary care. It also sets out some procedural steps necessary for a performance assessment system, including multi-dimensionality, shared design, evidence-based benchmarking of results, timeliness and transparent disclosure. Finally, it recommends some criteria to ensure relevant performance indicators are selected, for example: alignment of indicators with objectives of the health system, ability to routinely collect the indicator, the validity and reliability of information. The Opinion will feed into the work of the Member States’ group on Health Systems Performance Assessment (HSPA) on primary care, which will publish in the first quarter of 2018 a report on measuring primary care.