Disparities in access to gene therapy in the European Union: ethical and regulatory challenges

Gene therapies represent a significant advancement in modern medicine, offering potential cures for untreatable genetic disorders. However, equitable access to these innovative therapies remains a critical ethical challenge within the European Union (EU). This paper examines the adequacy of the EU's centralized market authorization framework, supplemented by alternative pathways such as the Hospital Exemption and Compassionate Use Program, in addressing access disparities. While the centralized framework ensures high standards of safety, quality, and efficacy, its implementation reveals significant barriers related to affordability, geographical disparities, and fragmented national healthcare systems. High costs create financial obstacles for both healthcare systems and individuals, disproportionately affecting low-income countries and regions. Geographic disparities are further exacerbated by fragmented regulations and uneven healthcare infrastructures across member states, limiting patient access in rural areas. Alternative pathways, while designed to improve access, suffer from inconsistent national-level implementation. This paper argues that as the EU navigates the complexities of gene therapy regulation, it must focus on creating a more cohesive and inclusive framework. By doing so, it can ensure that the potential of gene therapies is realized in a manner that benefits all EU citizens, irrespective of their geographic or economic circumstances.