Rebalancing innovation, affordability, and access for orphan drugs in the European Union

Hilde Stevens, Georges Siotis, Micael Castanheira, Mathias Dewatripont, Sanaé Akodad, Sam Daems, Alain Fischer and Michel Goldman

ULB Institutional Repository from ULB -- Universite Libre de Bruxelles

Abstract: Orphan drug policy in the European Union faces a double price-and-innovation gap: a small fraction of rare diseases receive important resources while the overwhelming majority are under- or un-researched, leaving most rare disease patients facing high unmet medical needs. The European Commission's reform proposals, notably the Pharma Package and the European Biotech Act, seek to rebalance incentives by adjusting market exclusivity. We argue that, while these reforms move in the right direction, they are insufficient to foster meaningful innovation while safeguarding affordability, and that a broader, more structural approach is needed. We show how proposals from the Draghi Report could complement the reforms through an EU-level HTA Coordination Office, a US-style EU ARPA-H, and expanded regulatory sandboxing. We then propose two additional instruments: public-private Special Purpose Vehicles to de-risk high-need innovation, and EU-level joint procurement to strengthen affordability and create predictable demand. Ultimately, only a coherent, well-calibrated framework can align industrial policy with the EU's ambition of leaving no rare-disease patient behind.

Keywords: Access; Affordability; Draghi Report; Drug pricing; EU Biotech Act; EU Pharma Package reform; Innovation incentives; Market exclusivity; Orphan medicinal products (OMPs); Policy; Rare diseases; Regulation (search for similar items in EconPapers)
Date: 2026-09
New Economics Papers: this item is included in nep-eur, nep-hea and nep-reg
Note: SCOPUS: re.j
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Published in: The Lancet Regional Health - Europe (2026) v.68

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