COVID-19, Geopolitics, and the Reform of European Pharmaceutical Law: Accelerating Enhanced Medicines Care for Europe?

Main Article Content

Kristine Plank

Abstract

Given the COVID-19 pandemic and intensified geopolitical disruptions, the European Commission, seeking to govern pharmaceutical supply, faced various problems from within and outside the European Union. The authority subsequently submitted far-reaching proposals to revise, amend, and repeal the European Union’s pharmaceutical law. It is against this backdrop that the article examines the different policy impacts on the new pharmaceutical legislation and makes a brief forecast about the extent to which the draft measures, should they come into force as proposed, will contribute to better medicines care in the future. In doing so, the analysis concludes that COVID-19 was a mere accelerator and not the original trigger of most legislative changes. Furthermore, the article argues that, although problems have been identified correctly, some of the approaches to solving them are entrenched in ineffective paths.

Keywords: COVID-19, Geopolitics, European Pharmaceutical Law, Accelerating Enhanced Medicines Care for Europe

Article Details

How to Cite
PLANK, Kristine. COVID-19, Geopolitics, and the Reform of European Pharmaceutical Law: Accelerating Enhanced Medicines Care for Europe?. Medical Research Archives, [S.l.], v. 12, n. 1, jan. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4915>. Date accessed: 21 dec. 2024. doi: https://doi.org/10.18103/mra.v12i1.4915.
Section
Review Articles

References

1. European Centre for Disease Prevention and Control. Communicable disease threats report, January 19-25, 2020. Accessed October 31, 2023. https://www.ecdc.europa.eu/sites/default/files/documents/communicable-disease-threats-report-25-jan-2020-PUBLIC.pdf

2. Müller A in Stüer B. Staat und Gesellschaft in der Pandemie. Sondertagung der Deutschen Staatsrechtslehrer in Wien. DVBl. 2021; (13):851-856.

3. Van Middelaar L. Das Europäische Pandämonium. Suhrkamp, Berlin; 2021.

4. Villareal PA. The multilevel dimension of rules-based disease surveillance beyond the state. Eur J Health Law. 2022;29(1):7-32. DOI: 10.1163/15718093-BJA10070.

5. World Trade Organization. WTO Dok. G/MA/QR/N/EU/4/Add.3; June 6, 2020.

6. EC. Communication on a coordinated economic response to the COVID-19 outbreak. COM(2020) 112 final. Brussels; 13. 3.2020.

7. EC. COVID-19. Guidelines for border management measures to protect health and ensure the availability of goods and essential services. COM(2020) 1753 final. Brussels; 16.3 .2020.

8. Plank K. German state aid for COVID-19 medicinal products: A risk for solidarity in the European Union. Eur J Health Law. 2022; 29(1):53-78. DOI:10.1163/15718093-BJA10061.

9. EC. EU strategy for COVID-19 vaccines. COM (2020) 245 final. Brussels; 17.6.2020.

10. EC. EU strategy on COVID-19 therapeutics. COM(2021) 355 final/2. Brussels; 6.5.2021.

11. Becker M. Ärger um deutsche Impstoff-Alleingänge. Spiegel 8.2021. Accessed 31 October, 2023. https://www.spiegel.de/politik/deutschland/corona-impfstoff-eu-aerger-um-deutsche-impfstoff-alleingaenge-a-acc65399-23ac-49a5-afee-b38831c822e9

12. Juncker J-C in Mayer T. Juncker: ‘Nach der Krise werden wir bessere Europäer sein.’ Interview with Jean-Claude Juncker. Der Standard. April 9, 2020: ‘Der europäische Geist ist in Gefahr.’

13. EC. A new industrial strategy for Europe. COM (2020) 102 final. Brussels; 10.3.2020.

14. EC. Updating the 2020 new industrial strategy: Building a stronger single market for Europe’s recovery. COM (2021) 350 final. Brussels; 5.5.2021.

15. Müller C. Indien stoppt Arzneimittel-Export – welche Arzneimittel könnten knapp werden? DAZ.online. March 4, 2020. Accessed October 31, 2-23. https://www.deutsche-apotheker-zeitung.de/news/artikel/2020/03/04/indien-stoppt-arzneimittel-export#:~:text=Die%20SARS%2DCoV%2D2%2D,Metronidazol%20und%20das%20Virostatikum%20Aciclovir

16. N.N. Ethik-Kommissionen fordern Sicherung klinischer Studien in der Ukraine und in Russland. aerzteblatt.de. March 11, 2022. Accessed October 31, 2023. https://www.aerzteblatt.de/nachrichten/132479/Ethik-Kommissionen-fordern-Sicherung-klinischer-Studien-in-der-Ukraine-und-in-Russland

17. Ziegler Y. Gutachten zur Entwicklung der Energiekosten im pharmazeutischen Großhandel. LLMM UG Pharma Consulting; May 1, 2023.

18. PHAGRO. Energiepreise verursachen Kostenexplosion im Pharmagroßhandel. Accessed October 21, 2023. https://www.phagro.de/energieversorgung/energiepreise-verursachen-kostenexplosion-im-pharmagrosshandel/

19. EC. Building a European Health Union: Reinforcing the EU’s resilience for cross-border health threats. COM(2020) 724 final. Brussels; 11.11.2020.

20. EC. Pharmaceutical strategy for Europe. COM(2020) 761 final. Brussels; 25.11.2020.

21. WHO. Statement on the fifteenth meeting of the IHR (2005) Emergency Committee on the COVID-19 pandemic. May 5, 2023. Accessed October 31, 2023. https://www.who.int/news/item/05-05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic

22. EC. Reform of the pharmaceutical legislation and measures addressing antimicrobial resistance. COM(2023) 190 final. Brussels; 26.4.2023.

23. EC. Proposal for a Directive of the European Parliament and of the Council on the Union code relating to medicinal products for human use, and repealing Directive 2001/83/EC and Directive 2009/35/EC. COM (2023) 192 final. Brussels; 26.4.2023.

24. EC. Proposal for a Regulation of the European Parliament and of the Council laying down Union procedures for the authorisation and supervision of medicinal products for human use and establishing rules governing the European Medicines Agency, amending Regulation (EC) No 1394/2007 and Regulation (EU) No 536/2014 and repealing Regulation (EC) No 726/2004, Regulation (EC) No 141/2000 and Regulation (EC) No 1901/ 2006. COM(2023) 193 final. Brussels; 26 .4.2023.

25. EC. The EU’s efforts to simplify legislation. 2019 Annual Burden survey. https://commission.europa.eu/system/files/2020-08/annual_burden_survey_2019_4_digital.pdf: 42-46

26. EC. Making the most of the EU’s innovative potential. An intellectual property action plan to support the EU’s recovery and resilience. COM (2020) 760 final. Brussels; 25.11.2020.

27. Schmitt C. Politische Theologie. Vier Kapitel zur Lehre von der Souveränität. 11th ed. Duncker & Humblot, Berlin; 2021.

28. Fuller LL. The morality of law. Revised edition. Yale University Press, New Haven, London; 1969.

29. Günther C. Legal vs. extra-legal responses to public health emergencies. Eur J Health Law. 2022; 29(1):131-149. DOI:10.1163/1571 8093-BJA10066.

30. Calliess C. Art 5 EUV Rn 6. In: Calliess C, Ruffert M. EUV, AEUV Kommentar, 5. Auflage, C.H. Beck, München; 2016.

31. Kingreen T. Art 168 AEUV. In: Calliess C, Ruffert M. EUV, AEUV Kommentar, 5. Auflage, C.H. Beck, München; 2016.

32. Berg W, Augsberg S. In: Becker U, Hatje A, Schoo J, Schwarze J. EU-Kommentar 4. Auflage Nomos, Baden-Baden; 2019.

33. Thym D, Bornemann J. Binnenmarktrechtliche Grundlagen des Infektions- und Gesundheitsschutzrechts. In Huster S, Kingreen T (eds.), Handbuch Infektionsschutzrecht, 65–90, paras 51ff. C.H. Beck, Munich; 2021.

34. EUGH Urt. V. 5.10.2000 – C-376/98, ECLI: EU:C:2000:544.

35. IQWiG. Comment by the Institute for Quality and Efficiency in Health Care of 7 June 2023 on the European Commission’s Proposal of 26 April 2023 on the Reform of the EU Pharmaceutical Legislation. Cologne; 7.6.2023.

36. Ruffert M. Art 288 AEUV. In: Calliess C, Ruffert M. EUV, AEUV Kommentar, 5. Auflage, München; 2016.

37. Schwarze J, Becker U, Pollak C. The implementation of Community law – Studies in the legislative and administrative policies of the European Community and its Member States, 67 ff. Nomos, Baden-Baden; 1994.

38. Schwarze J, Mellein C. Targeted review of EU pharmaceutical legislation – The Community Code on Medicinal Products needs to remain a Directive. EPLR. 2021; (1):4(16 ff.).

39. EC. Combined evaluation roadmap/ inception impact assessment, Ref. Ares (2021) 2185074. Brussels, 3 2021.

40. EC. Health Union: Identifying top 3 priority health threats. Accessed October 31, 2023. https://health.ec.europa.eu/system/files/2022-07/hera_factsheet_health-threat_mcm.pdf

41. Breyer F, Zweifel P, Kifmann M. Gesundheitsökonomik. 6th ed: 179-245. Springer, Berlin, Heidelberg; 2013.

42. EC. A European One Health action plan against antimicrobial resistance (AMR). Accessed October 31, 2023. https://health.ec.europa.eu/system/files/2020-01/amr_2017_action-plan_0.pdf

43. EC. Council Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach. 2023/C 2020/01. Luxemburg; 13. 6.2023.

44. Hosseini M, Baur M. Marktversagen bei der Arzneimittelversorgung am Beispiel von Antibiotika. Covid-19 wirft Schlaglicht auf das Problem – ist aber nicht dessen Ursache. In: Neustart der Industrie unter dem Einfluss von Covid-19: Wie bereit ist die globale Lieferkette? Accessed October 31, 2023. https://www.ifo.de/DocDL/sd-2020-05-goerg-moesle-etal-corona-globale-lieferketten.pdf

45. Bayerlein M. Offene strategische Autonomie der EU im Bereich Arzneimittel. SWP-Aktuell December 2022 (No. 75). DOI:10 .18449/2022A75.

46. EMA. PRIME: Analysis of the first 5 years’ experience. Updated April 5, 2022. Accessed October 31, 2023. https://www.ema.europa.eu/en/documents/report/prime-analysis-first-5-years-experience_en.pdf

47. Donati A. The conditional marketing authorisation of COVID-19 vaccines: A critical assessment under EU law. Eur J Health Law. 2022;29(1):33-52. DOI:10.1163/ 15718093-BJA10065.

48. Marinus R, Mofid S, Mpandzou M, Kühler TC. Rolling reviews during COVID-19: The European Union experience in a global context. Clin Ther. 2022; 44(3):352-363. DOI:10.1016/j.clinthera.2022.01.001.

49. Cowlishaw S, Handy E. EU Pharma Legislation Review Series: Temporary emergency marketing authorizations. Covington 3.5.2023. Accessed October 31, 2023. https://www.insideeulifesciences.com/2023/05/03/eu-pharma-legislation-review-series-temporary-emergency-marketing-authorizations/

50. EC. Decision of 16.9.2021 establishing the Health Emergency Preparedness and Response Authority. C(2021) 6712 final. Brussels; 16.9.2021.

51. EC. Communication on introducing HERA, the European Health Emergency Preparedness and Response Authority, the next steps towards completing the European Health Union. COM (2021) 576 final. Brussels; 16.9.2021.

52. European Parliament. Medikamentenengpässe in der EU: Ursachen und Lösungen. Accessed October 31, 2023. https://www.europarl.europa.eu/news/de/headlines/society/20200709STO83006/medikamentenengpasse-in-der-eu-ursachen-und-losungen

53. EC. Future-proofing pharmaceutical legislation – study on medicine shortages: final report (revised) 12.2021.

54. Joachimsen K. Worauf es jetzt ankommt. In: Neustart der Industrie unter dem Einfluss von Covid-19: Wie bereit ist die globale Lieferkette?. Accessed October 31, 2023. https://www.ifo.de/DocDL/sd-2020-05-goerg-moesle-etal-corona-globale-lieferketten.pdf

55. Hagemeyer-Witzleb TM. The international law of economic warfare. Cham; 2021.

56. PwC. 25th Annual global CEO survey: Reimagining the outcomes that matter. Accessed October 31, 2023. https://www.pwc.com/gx/en/ceo-survey/2022/main/content/downloads/25th_CEO_Survey.pdf

57. EC. Proposal for a Regulation establishing a framework for ensuring a secure and sustainable supply of critical raw materials. COM (2023) 160 final. Brussels; 16.3.2023.

58. EC. Guidance to Member States concerning foreign direct investment and free movement of capital from third countries, and the protection of Europe’s strategic assets. 2020/C 99 I/01.

59. Plank K. Medicinal products and the screening of foreign direct investment. Questionable protection of national security interests by tightening investment control law. EPLR. 2021;(3):123-128.

60. Espinoza J. Vestager urges stakebuilding to block Chinese takeovers. Financial Times. April 12, 2020.

61. PTI. U.S. defends restrictions on export of COVID-19 vaccine raw materials amid India’s request to lift ban. The Hindu. April 23, 2021.

62. EC. Press release: rescEU: EU entwickelt strategische Reserven für chemische, biologische und nukleare Notfälle. April 6, 2022. Accessed October 31, 2023. https://germany.representation.ec.europa.eu/news/resceu-eu-entwickelt-strategische-reserven-fur-chemische-biologische-und-nukleare-notfalle-2022-04-06_de

63. N.N. EU richtet weitere Vorräte gegen nukleare und chemische gefahren ein. Deutsches Ärzteblatt, February 2, 2023. Accessed October 31, 2023. https://www.aerzteblatt.de/nachrichten/141150/EU-richtet-weitere-Vorraete-gegen-nukleare-und-chemische-Gefahren-ein

64. Münkler H. Welt in Aufruhr. Rowohlt-Berlin. Berlin; 2023.

65. Badrot A. In: Mullin R. COVID-19 is reshaping the pharmaceutical supply chain. C&EN. 2020; 98(16). Accessed October 31, 2023. https://cen.acs.org/business/outsourcing/COVID-19-reshaping-pharmaceutical-supply/98/i16

66. Laforce R. In: Mullin R. COVID-19 is reshaping the pharmaceutical supply chain. C&EN. 2020; 98(16). Accessed October 31, 2023. https://cen.acs.org/business/outsourcing/COVID-19-reshaping-pharmaceutical-supply/98/i16

67. Van de Wiele VL, Raymakers A, Kesselheim AS, Rome BN. Transferable exclusivity vouchers and incentives for antimicrobial development in the European Union. J Law Med Ethics. 2023;51:213-216. DOI:10.1017/jme.2023.58.

68. DSV. Stellungnahme der Deutschen Sozialversicherung vom 16. Oktober 2023 zur Reform des EU-Arzneimittelrechts. Short version: https://dsv-europa.de/lib/02_Positionspapiere/2023/20231016_DSV-Position-in-Kuerze_Arzneimittelreform_DE.pdf; long version obtained by the author

69. OECD. Shocks, risks and global value chains: insights from the OECD METRO model. June 2020. Accessed October 31, 2023. https://www.oecd.org/trade/documents/shocks-risks-gvc-insights-oecd-metro-model.pdf

70. Calliess C. Braucht die Europäische Union eine Kompetenz zur (Corona-) Pandemiebekämpfung? NVwZ. 2021;40(5):505-511.