Acting with foresight in times of budget austerity

Horizon scanning is acknowledged to be one of the key components of a demand-driven healthcare system. We propose it to be a dynamic collaborative process driven by national unmet need matched with continued insight into the innovative pharmaceutical industry medicinal pipeline. Summer 2019 an international agreement was reached between payers to set up and commission an international horizon scanning initiative (IHSI), which is the international front-end of such a system. In this Policy Paper we propose a two-stage structure and organisation of the back-end national part of the horizon scanning process still to be implemented. This will lead to healthcare budgets managed with better foresight, a necessity in the face of breakthrough, some potentially curing therapies coming at a high cost. Taking the Belgian national component of the proposed horizon scanning system to implementation will require a pilot to be carried out. This to test the internal and external validity of the proposed design