Cost containment of expensive drugs from a university hospital's perspective: Discovering new routes to safeguard accessibility to innovative medicinal therapies

The increasing costs of innovative medicines pose a threat to the accessibility of healthcare systems worldwide, despite the improved quality of life and survival rates these medicines often offer. It is important to ensure access and promote innovation, especially given the emergence of very expensive treatments such as gene and cell therapies.

This dissertation investigates ways to contain the costs of innovative medicines from the perspective of university hospitals. These hospitals play a crucial role in the entire lifecycle of medicines, from fundamental research and clinical trials with patients, to the procurement, prescription, distribution, and administration of medicines to patients. With this involvement, university hospitals have a significant social responsibility to ensure the accessibility and affordability of innovative medicines, in line with the European Pharmaceutical Strategy of 2020.

The dissertation highlights the role of university hospitals in the various phases of the drug life cycle and explores how this role can be more effectively utilized. Key findings include intensifying involvement in drug research and attention to efficient prescribing, along with a call for system disruption by adding competitive elements. The first suggestion is to make greater use of the potential for local production of medicines through hospital pharmacies. The second is to give university hospitals more involvement and ownership in the research, registration, and market introduction of self-discovered medicines. Both require a mission-oriented approach, interdisciplinary collaboration on a European scale, societal engagement, the adoption of new technologies, and above all, courage.