In this paper, we explore a range of recent cross border collaborations in Europe that will affect the European market access environment.  These include:

  1. Small groups of countries conducting joint healthcare technology assessment (HTA) and price negotiations
  2. Increased official or unofficial price referencing
  3. EU-wide initiatives, e.g., HTA harmonization, evidence generation requirements, real world evidence (RWE)

In particular, we outline their progress to date, their likely future impact, and potential implications for biopharma companies.