Mr. Shaun Flanagan:

As regards the three, six, nine issue, companies do enter the market in waves. I have explained throughout how we use HTA. I should also probably have said that in 2008, 2010, 2012 and 2013 there were price realignments on the basis of what the baskets were in those countries. Those were many years after the launch. I have no doubt our expectation is that in the next agreement there will be an automatic realignment in various things. In the last agreement the decision was made to take all the savings we can up front, and we realigned everything at the start of the agreement, as opposed to doing it on a phased basis. I think, however, that in the next agreement there will be an automatic realignment.

The other thing that happens is that when a company makes an application there may well be only three baskets on it. They go through the HTA process and we end up in a commercial negotiation. One of the things we always do is go back to companies and say, "Show us your basket of nine now, guys". Often at that stage one will have seven, eight or nine in the basket. As soon as that happens, one is usually in a better position for leverage.

In addition, while companies submit the basket of three to us, it does not mean that we stop on that day. We have relations with other reimbursement agencies across Europe. When we see an opportunity where somebody has launched at a lower price, that gives us a commercial opportunity to negotiate with a company. We do go back and do that.