In France, doctors within the national healthcare system can readily prescribe the cancer drug Avastin, manufactured by Roche, but that's not generally the case across the English Channel in the UK, where patients must meet a much stricter set of criteria to receive the medicine. Given that both countries reside within the EU, where the European Medicines Agency (EMA) makes approval decisions for drugs and devices, it's perhaps surprising to find this type of discrepancy. The reason is that once a product is given marketing authorization by the London-based EMA, decisions about whether the therapy will be covered and how much its manufacturer will receive for it from national healthcare systems are left to individual EU countries to sort out.
Just because a drug has been approved by the EMA doesn't make it cost effective or even better than another drug that is already available. As such, each country has a regulatory entity known as health technology assessment (HTA) body, which assesses the clinical and cost effectiveness of a given drug or device before making recommendations to the organizations that pay for that product within the national healthcare system. With each country making these determinations according to their individual protocols, this can lead to duplication in the work that companies and HTA bodies put in. To remedy these redundancies, efforts are gathering pace to streamline the way medical devices and drugs are assessed and reimbursed in different European countries.
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