EMA Could Lose a Majority of Its Staff in Post-Brexit Relocation

This week, the European Medicines Agency (EMA) issued an update on its business continuity plan in preparation for the agency’s relocation. The EMA must move from its current location in London as the United Kingdom finalizes its withdrawal from the European Union.

As the focal point of its update, the EMA made public the results of a survey completed by 92% of EMA staff, which indicated that, for 65% of respondents, the eventual location of the EMA will be a determining factor in their decision to remain with the agency. In the worst-case scenario, the plan said, the agency could be left unable to function, and “As there is no backup, this would have important consequences for public health in the [European Union, EU].”

In the survey results, the EMA did not specify which cities had garnered higher or lower prospective retention rates, but disclosed that the top-ranking location was one to which 81% of respondents were likely or very likely to relocate. The lowest-ranking city was one to which only 6% of respondents were likely or very likely to relocate.

Using the survey results, the EMA broke the candidate locations into 4 groups:

• Group 1. The 5 cities comprising this group had an average projected retention of 73% (range, 65% to 81%). It would take the EMA 2 to 3 years to fully recover from this move, though approvals of new medicines and safety monitoring would largely be maintained. Progress on public health initiatives would likely slow.
• Group 2. This group of 5 cities had a projected retention of 54% (range, 51% to 60%). The EMA estimates that it would take 3 to 5 years to recover fully from a relocation to one of these cities, and: Patients would wait longer for new medicines Safety monitoring would require deprioritizing other tasks Public trust in the EMA would likely erode Europe could lose its place at the forefront of scientific research Implementation of EU legislation concerning medicines and devices would be delayed
• Group 3. The single city in this group would likely retain 48% of EMA staff, and it would take the agency 5 to 10 years to recover. Patients would be at serious risk because of the following: Delays in access to medicine and poor safety monitoring Innovation would likely suffer Some drugs would become unavailable in some EU member states Patients would have unequal access to treatment
• Group 4. In this group of 8 candidate cities, the average projected retention is only 18% (range, 6% to 28%). The EMA says that permanent damage would be done to its system, and that it would be unable to operate, leading to a public health crisis: The EU’s single market for medicines would likely dissolve Medicines would become unavailable Importation of therapies from other nations would be required EU drug approvals would likely be based on FDA and Japanese approvals

The 19 cities with pending offers to host the EMA are as follows, in alphabetical order: Amsterdam, Netherlands; Athens, Greece; Barcelona, Spain; Bonn, Germany; Bratislava, Slovakia; Brussels, Belgium; Bucharest, Romania; Copenhagen, Denmark; Dublin, Ireland; Helsinki, Finland; Lille, France; Malta; Milan, Italy; Porto, Portugal; Sofia, Bulgaria; Stockholm, Sweden; Vienna, Austria; Warsaw, Poland; and Zagreb, Croatia.

European ministers will determine a new location for the EMA by vote in November, 2017. Under the complex voting system, each EU member state will be allowed to give 3 votes for its first choice, 2 for its second choice, and 1 for its third choice. If a city earns at least 14 separate 3-point votes, it will be named the winner. Otherwise, a second round of voting will proceed with a run-off among the 3 highest-scoring cities, with each member nation having 1 vote. In the event that no winner is determined in this second round, a final run-off will be held between the top 2 cities.