EU Cross-Border Healthcare: ‘challenges remain’

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European Union flags in front of the blurred European Parliament in Brussels, Belgium

According to a report from the Commission of the European Union on patients’ rights under the Cross-Border Healthcare Directive, and its impact ten years after its adoption, patients’ rights in cross border healthcare are well protected, but there are continued difficulties when seeking treatment abroad.

The Commission of the European Union has published a report on patients’ rights under the Cross-Border Healthcare Directive as well as an assessment of its impact ten years after its adoption.

The report has confirmed that the directive has guaranteed equal treatment to all European patients when treated in another EU country.

It confirmed that it provided for partial or full reimbursement of costs of care at cross-border healthcare facilities,

Commissioner for Health, Stella Kyriakides, said that the COVID-19 pandemic had shown the importance of cross-border EU solidarity in a time of crisis. She also said that it is encouraging to see that the legislation of the EU is fulfilling its objective of facilitating equal access and treatment as well as quality healthcare for patients across the EU.

Kyriakides adds: “We will now take action to tackle the remaining challenges and ensure that all patients can make full use of their rights to healthcare under EU law. Ensuring strong European cooperation in cross-border healthcare is an important part of our action to build a strong European Health Union, serving all patients.”

The European Commission notes that the recognition of prescriptions in the EU and the right of patients to information on cross-border healthcare are further proof of the Directive’s value. It also recognises that thousands of patients suffering from rare or complex diseases have been helped by the European Reference Networks.

Residents of border regions have also benefited greatly from structured regional cooperation between healthcare providers and administrations that work together across borders to overcome the differences in the healthcare systems and meet patients’ needs.

But patients continue to face difficulties when seeking treatment abroad.

The report states that the difficulties that EU patients face are due to uneven application of the directive, cumbersome administrative procedures and overly complex information on the best cross-border healthcare options available.

The evaluation admits that the main problem that patients have is that they are often expected to pay up front and only get reimbursed many months later. But the EC defends this as the only viable way for patients to choose between public and private healthcare without prior approval.

What the evaluation skates over is that in reality the vast majority of Europeans have no knowledge of their rights to be treated in another country.

EuropaBio, the European association for bioindustries believes that a well-functioning EU cross-border healthcare framework is necessary to enable patient access to specialised treatments and novel therapies when these are not available in their home country. It warns about the limited success of the Directive to date, as exemplified by the small number of EU citizens aware of and making use of the possibilities offered by the Directive, the disproportionate administrative burden, and continued uncertainty about costs abroad and reimbursement. After more than ten years, the Directive’s objectives have not been fully realised for the benefit of patients, and serious gaps remain. EuropaBio regrets the lack of ambition for the Directive and urges the European Commission to revise the Directive to address the shortcomings highlighted by the evaluation. It is necessary to address persisting barriers, such as long approval times, fragmented payment and reimbursement processes, difficult access to clinical trials, and disjointed implementation that hinders patients’ access to excellence of care and innovative therapies.

EuropaBio calls upon the Commission to convene a structured dialogue with the Member States and other stakeholders to ensure better functioning of the Directive’s implementing measures.

The bottom line is that revisions to the directive or any campaign to improve how it works, is way down Europe’s list of priorities.