Key Takeaways
- CEE as a growth frontier. Central and Eastern Europe is experiencing rapid healthcare spending growth (48% from 2018–2022), strong economic drivers, and broad adoption of innovative therapies, making it a high-potential market no longer just a secondary consideration.
- Innovation and access are accelerating. Many CEE countries reimburse most major new therapies, have transparent HTA systems, and achieve market access timelines comparable to Western Europe; delays often stem from pharma’s own launch strategies.
- Pricing power and strategic opportunity. CEE markets can secure list prices at or above EU averages, use innovative contracting, and pose minimal spillover risk to EU-4 pricing, making them viable for earlier launches and competitive positioning.
Central and Eastern Europe (CEE) has long been misunderstood by global pharmaceutical leaders—a region often sidelined in favor of the more “mature” Western European markets. But that view is no longer sustainable. In a robust analysis of 33 innovative therapies—including blockbusters, novel European Medicines Agency-approved drugs, and CAR-T therapies—the global consultancy Simon-Kucher challenged six persistent myths that have shaped pharma’s go-to-market strategies in CEE markets. The verdict? These myths are not just outdated—they’re holding the industry back.
Myth 1: CEE markets have only limited market potential
While CEE accounts for just 8% of EU healthcare expenditure today, the region represents 23% of the EU population. Healthcare spending grew by an astonishing 48% between 2018 and 2022, nearly double the EU-4 rate (France, Germany, Italy, and the UK), signaling powerful structural drivers—economic growth, healthcare modernization, and urbanization—are already in motion.
The verdict: CEE is no longer a marginal opportunity; it is a growth frontier.
Myth 2: CEE markets have reluctance toward pharma innovation
Despite modest healthcare budgets, countries such as the Czech Republic, Poland, and Romania reimburse up to 79%-88% of major innovative therapies—comparable to EU-4 markets. New funding schemes, such as Poland’s Medical Fund and Romania’s Health Innovation Pact, show the region’s commitment to accelerating access for innovative drugs.
The verdict: CEE isn’t avoiding innovation—it’s investing in it strategically.
Myth 3: CEE markets have opaque pricing and market access processes
Far from ad hoc, most CEE countries now follow standardized health technology assessment (HTA) pathways similar to EU-4 markets. Structures such as Poland’s AOTMiT or Romania’s scorecard-based HTA prove that decision-making is rule-based, transparent, and increasingly harmonized via initiatives such as the EU Joint Clinical Assessment.
The verdict: What appears opaque is often just unfamiliar.
Myth 4: CEE markets have excessive time to access
Yes, access delays exist—but they’re largely self-imposed. In markets such as Poland, the internal pricing and market access process averages just 318 days, comparable to EU peer markets. Most delays come from pharma companies themselves, who often wait to launch in CEE markets to protect international reference pricing (IRP)-sensitive dynamics in Western European markets.
The verdict: The bottleneck isn’t in regulation—it’s in strategy.
Myth 5: CEE markets have low list prices
Data shows that CEE markets can command equal or even higher list prices than the EU average—especially for newer therapies. Croatia, Czechia, and Poland list CAR-T treatments above average benchmarks. What’s more, confidential discounting and innovative contracting (e.g., outcome-based agreements) are now standard in most CEE markets.
The verdict: CEE pricing is not a race to the bottom—it’s a negotiation table worth sitting at.
Myth 6: CEE markets have spillover threat to EU-4 pricing
The IRP cascade is one-directional: CEE markets reference EU-4, not vice versa. Germany doesn’t use IRP at all. France excludes CEE markets entirely. With two-tier pricing systems and sophisticated IRP management, the actual spillover risk is negligible.
The verdict: Defensive launch delays based on spillover fears are a strategic misfire.
The strategic imperative: Act now
The data is unequivocal: CEE markets are evolving faster than industry perceptions. Companies clinging to outdated assumptions risk not just lost revenue—but also diminished impact on patient access and regional brand trust.
This isn’t just a call for market access reform. It’s a call for executive recalibration. Treating CEE as a secondary priority is no longer justifiable—neither economically nor ethically.
The message to pharma leaders: The time to act is now.
Christian Schuler is Senior Partner and Managing Partner, Global Health Sector, Simon-Kucher, Munich; Wiktor Miller is Senior Manager, Simon-Kucher, Warsaw
