LAUSR

The Beneluxa collaboration is an initiative aimed at securing sustainable access to new medicines. It was established in April 2015 by Belgium and the Netherlands. Luxembourg and Austria have joined since. Ireland became a member in June 2018. Beneluxa’s stated goal is to ensure “timely access and affordability of medicines” [1]. It aims to achieve this through five principal activities: joint horizon scanning; mutual recognition of heath technology assessments (HTAs); sharing policy expertise and best practice; enhanced bargaining power through joint price negotiation; and, improved price transparency [1]. The initiative’s organisational structure and member mutual responsibilities are documented in their terms of reference [2]. Ireland’s admission to the group was welcomed by Irish Minister for Health, Simon Harris, with claims that Beneluxa will assist Ireland by “ensuring that medicines can be sourced at a price that is affordable and sustainable in the context of the ever competing demands for resources rights [sic] across our health service” [3]. This commentary considers why such optimism might be misplaced due to the potential challenges of collective bargaining and mutual HTA recognition among states with different HTA decision processes. It explains why political involvement in decision making will likely compromise collective action. It concludes with an outline of what positive benefits could stem from methods collaboration between members. While the editorial is written from an Irish perspective, the issues apply to other members of the initiative. 1 Divergence in Health Technology Assessment (HTA) Methods