The Beneluxa Initiative on Pharmaceutical Policy has published a list of pipeline medicines that its five members – Austria, Belgium, Ireland, Luxembourg and the Netherlands – consider suitable for closer cooperation during pricing and reimbursement. Companies with medicines on the list are invited to contact the Beneluxa secretariat to discuss a possible joint pilot.
The exercise starts before national reimbursement applications are submitted. Beneluxa has selected 17 pipeline medicines from the 2025 High Impact Reports produced by the International Horizon Scanning Initiative. It says these may be suitable for a joint HTA alone or for assessment followed by a joint price negotiation involving at least three Beneluxa countries.
The Initiative has used this approach before. Belgium and the Netherlands jointly assessed and negotiated nusinersen in 2018. Belgium, Ireland and the Netherlands later used a joint assessment as the basis for negotiations on atidarsagene autotemcel. They eventually reached a common pricing agreement in January 2024, allowing reimbursement in all three countries.
The arrival of EU Joint Clinical Assessment (JCA) changes part of this model. For medicines covered by the EU HTA Regulation, the EU process now produces the common assessment of relative clinical effectiveness and safety. Beneluxa does not decide which medicines enter JCA, although its national HTA bodies participate extensively as assessors and co-assessors.
JCA stops before the decisions that determine access. Countries still decide how they judge clinical added value in their own health systems and remain responsible for economic assessment, willingness to pay, pricing and reimbursement. These are therefore the areas where cooperation between Beneluxa payers can continue after the EU clinical report is available.
The July publication also adds to signs of renewed activity after a period with relatively few publicly announced joint negotiations. Beneluxa appointed its first General Manager in late 2025, and its January 2026 work programme included both prospective identification of medicines and work to improve joint reimbursement negotiations. In June, the five countries called for closer European cooperation on pricing and reimbursement.
As JCA expands, Beneluxa's original role in producing joint clinical assessments should become less prominent. Its more distinctive role may increasingly lie further downstream: identifying suitable products early, aligning national assessments of value and affordability, and giving several smaller national payers the option of negotiating reimbursement terms with a manufacturer together.
Source: Beneluxa Initiative
Link: The Beneluxa Initiative identified impactful medicines suitable for joint HTA submission
Date: 17 July 2026
Source: Beneluxa Initiative
Link: Steering Committee Meeting and General Assembly of the Beneluxa Initiative in Dublin, Ireland
Date: 20 January 2026
Source: European Parliament and Council of the European Union
Link: Regulation EU 2021/2282 of the European Parliament and of the Council of 15 December 2021 on health technology assessment and amending Directive 2011/24/EU
Date: 22 December 2021
