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In 2017, the European Medicines Agency staged the first effort at democratic innovation within transnational European Union institutions directly influencing the transnational regulation of medicines. Alongside its public consultation on epilepsy drug Valproate, European Medicines Agency included a public hearing involving representatives of patients and testimony from those directly affected by the medicines. Using this critical case study, the article argues from a deliberative democratic perspective that although the hearing in many ways exhibited the traditional shortcomings of elite-driven deliberation, it also demonstrated unexpected and surprising deliberative qualities. Based on new quantitative analysis of the hearing using the Discourse Quality Index, and qualitative observation of over 4 hours of footage, the article argues European Medicines Agency’s hearing facilitated equitable access and influence of patients and members of the public who had previously been excluded from decision making on drug distribution. These findings provide important new evidence of the deliberative democratic value of public hearings.

Can independent regulatory agencies mend Europe’s democracy? The case of the European Medicines Agency’s public hearing on Valproate