More than two decades of US purchasers essentially allowing pharmaceutical manufacturers to charge whatever they want have resulted in US companies' global leadership in biomedical sciences. President Donald Trump's proposed "most favored nation" drug pricing policies are causing a shift, whereby drugs' value stops being a national conversation and becomes a mechanical convergence of prices under US pressure and under coming threat of new, fierce competition. Presumably, the proposed policies could lead to higher drug prices in the European Union (EU), but they will hardly generate more income for US pharmaceutical companies, which might even stay away from European markets to avoid having to disclose their EU net prices, unless they develop global breakthrough competitive strategies. The proposals certainly will change EU manufacturers' investment strategies and are already accelerating the polarization of their national price negotiation goals and methods. Within this new geopolitical context, European nations' policies should be driven by a much more holistic and strategic approach to what "value" means.
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F. Megerlin
Health Affairs
Université de Strasbourg
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F. Megerlin (Wed,) studied this question.
www.synapsesocial.com/papers/69d892886c1944d70ce03e6c — DOI: https://doi.org/10.1377/hlthaff.2026.00115