Editorial: Pharma’s Reluctance To Serve Europe To Dodge MFN Drug Pricing Is Chilling

EU and US crisis concept as a Broken Rope stretched with force and stressed to a decoupling metaphor for pressure on the economic and political relationship between Brussels and Washington.

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As Big Pharma companies consider foregoing European drug launches to avoid reducing drug prices in the U.S. in alignment with Trump’s Most Favored Nation policy, patients will suffer.

The pharmaceutical industry’s giants succeeded last year in shifting some of the concerns about drug pricing onto pharmacy benefit managers, while publicly agreeing with the White House to lower some prices. These splashy announcements helped create the illusion that action had been taken to help Americans pay less for their prescription medicines, and the pharma industry enjoyed a slight improvement in its image. The CEOs, the faces of these companies, were appearing before the general public pledging to drop prices. It was all great stuff.

But many analysts and other industry experts believe that didn’t really happen, as the prices for many of the medicines offered on the TrumpRx platform were already declining.

Even the prices for GLP-1 medicines, which indeed came down, were more driven by market dynamics than a directive from the president.

And now, a darker side of these efforts to duck President Donald Trump’s Most Favored Nation drug pricing initiative is becoming apparent. Companies are now planning to skip launching new medicines in some European nations to avoid setting a reference price that might reduce how much they can charge in the U.S. Insmed is delaying the launch of inflammatory lung disease drug Brinsupri even though it’s been cleared in Europe.

Following Insmed’s decision to hold off on launching a newly approved lung disease drug in Europe, experts anticipate more companies will do the same as they seek to avoid price erosion in the U.S. Will Chinese biotechs fill the void?

Others are reassessing their strategies, too, according to a recent report from Reuters. “We’re seeing first signs of delayed introductions into Europe,” Stefan Oelrich, a Bayer executive and president of trade group the European Federation of Pharmaceutical Industries and Associations, told the outlet.

I spend a lot of time trying to reveal the human side of this business. The people and scientists who create and innovate, cure diseases and inspire medical breakthroughs. They save lives. I hear all the time that the work pharmas do is all about the patients.

Is this about the patients? Withholding promising new drugs from Europeans so that Americans can be charged more?

This doesn’t seem to help anyone at all. Americans still get charged exorbitant amounts for new medicines—likely amounts that the average person can’t afford—and Europeans don’t get them at all.

I get it. We have to pay for innovation somehow. The U.S. is the biggest and most lucrative market in the world. I don’t have a solution, but I know for sure that withholding important medicines from patients who desperately need them isn’t it.

Elsewhere, Doctors Without Borders/Médecins Sans Frontières (MSF) launched a public campaign this week to pressure Gilead into selling its newly FDA-approved HIV prevention medication Sunlenca. The nonprofit claims that, while they can afford the product, Gilead is refusing to boost production beyond a supply of 2 million that has been provided to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Only a handful of the top pharmas have signed Most Favored Nation drug pricing deals with the White House, while smaller biotechs continue to hang in limbo.

MSF claims that this isn’t enough, and that many countries that need the medicine can’t get it due to restrictions placed by Gilead.

“Gilead must decide whether it prioritizes protecting people or protecting control and profit,” said Tom Ellman, director of MSF’s Southern Africa Medical Unit. “This is a chilling echo of the policies we saw in the 1990s when antiretrovirals were provided to those in the Global North while the rest of the world was denied access and many lives were lost to HIV/AIDS.”

In a statement, Gilead did not respond directly to the situation with MSF but said the company is “committed to ensuring broad, sustainable access to lenacapavir for HIV prevention in high‑incidence, resource‑limited countries.” Gilead is working with other organizations and initiatives, including the Global Fund and the President’s Emergency Plan for AIDS Relief (PEPFAR) to provide access to the preventative drug and generics manufacturers have been granted early access to produce copies of it. Let’s hope these parties can come together to provide these nations with everything they need to prevent HIV.

Any actions that restrict patient access to desperately needed medications are indefensible. I agree with MSF. This moment in pharma’s history is chilling.

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