Abstracts from the 5th PPRI conference 2024: ensuring access to affordable medicines through innovative policies, Vienna, Austria, 25–26 April 2024

Global spending on pharmaceuticals is forecast to exceed pre-pandemic outlook to $1.2 trillion by 2028 (IQVIA, 2024).Health systems across the world face increasing calls for access to highly innovative, and often very expensive, medicines for patients with significant unmet need.Exciting new developments in science and technology give rise to ever more personalised medicines, pushing the boundaries of existing regulatory, pricing and reimbursement systems.Apart from high prices, the challenges for countries are wide ranging.From a lack of generic competition, disparities in access, inadequate health insurance coverage, supply chain disruptions, to policy and regulatory challenges.Strategies to overcome these challenges require the adoption of multi-faceted approaches.Different approaches are needed in high, middle, and low-income countries.The question of affordability could be a relatively straightforward one if there was a high degree of certainty about the benefits of expensive medicines.However, regulators are speeding up evaluation, taking the advantage of new approaches to evidence collection and analysis, including real-world evidence.Fewer medicines are coming to market with an open and shut case for value, leaving payors and commissioners with significant (financial) risks to manage.In