Internal drivers of change

• Information sharing
• Open collaboration with stakeholders
• Convergence of marketing authorisation and HTA operations
• Digitalisation
• Time- and location-independent work
• Concentration on core competencies

External drivers of change

• Regressing Europe, growing East Asia
• Unpredictability and proneness to crises
• Globalisation, centralisation, polarisation
• Crime and risks within the pharmaceutical sector
• Empowerment of citizens
• Flood of information

Drivers of change within the state

• The Health Care Reform
• Blurring of organisational boundaries
• Openness, transparency, ethical operations, responsibility
• Savings
• Shared support services
• Ministry of Finance, the state parent company
• Independence from time and location

Technological drivers of change

• 24/7 online world
• Expensive advanced therapies
• Preventive and curative pharmacotherapies
• ATMP products, implants, diagnostics
• Automated distribution of medicines
• Technology and cyber security audits