It is time for payers to stop passively accepting uncertainty and instead help to generate evidence on new medicines, says Hans-Georg Eichler from Austria’s association of insurers.

With talks to form a new coalition progressing in Germany, the new government, which could take office in early December, is expected to introduce measures to curb pharmaceutical spending. Orphan drugs could be among products targeted.

The G-BA, the body in charge of Germany’s pricing and reimbursement process, has confirmed that Novartis’s gene therapy Zolgensma (onasemnogene abeparvovec) offers no additional benefit over Biogen’s Spinraza (nusinersen) for treating spinal muscular atrophy.

Alexander Natz, secretary general of EUCOPE, warns that changes to a pricing and reimbursement system that has so far worked well, particularly for orphans, could dissuade advanced therapy medicinal products manufacturers from launching in Germany.

The Scottish health technology appraisal body also OKd Janssen's Ponvory and new indications for AstraZeneca’s Tagrisso, Roche’s Tecentriq and MSD’s Keytruda. It also said it could not make recommendations on a number of drugs because manufacturers had not made a submission to the SMC.

After years of wrangling, the legislative process for new regulation on greater cooperation on health technology appraisals across the EU has entered its final stages, with parliament expected to adopt the legislation soon.