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KCE Reports 381C (2024) Forecasts of future spending on medicines are currently based mainly on past spending and trends. However, this approach does not adequately predict the impact of very expensive emerging drugs, such as cell and gene therapies. To identify those products and prepare the system for their arrival, the pharmaceutical pipeline needs to be systematically monitored. This is known as horizon scanning. KCE has issued recommendations to better predict future spending on pharmaceuticals, with particular emphasis on horizon scanning.