Trump’s MFN Drug Pricing Policy Is Cutting Europe’s Access to New Medicines

Europe is quietly losing access to new medicines, and the slide began before many people found the words for it. Ten months into Donald Trump’s MFN drug pricing policy, roughly 35% of new products are no longer reaching the European market. Known formally as the Most Favored Nation order, the policy ties US prices to those paid in comparable countries, and its effects now reach far beyond American patients. Christoffer Frendesen, a Brussels-based pharmaceutical journalist and former policy advisor to Danish MEPs, has been tracking the launch data and the silence around it. He joins host Nathalie Lahitte for the opening episode of the Pharma Minds series “Europe’s Access Dilemma”, a five-part look at whether the continent can still afford and access innovation.

Countries picked as reference markets under the MFN framework are feeling it first, but the drop in launches runs across the continent. Frendesen described the scale:

“It’s from between 35% for some European countries up to above 40 for some European countries.”

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The MFN drug pricing policy no one wants to discuss

Frendesen has spent months talking to industry leaders and policy officials in Brussels, and the reaction he keeps hearing is a mix of alarm and silence. He said:

“They are all very concerned about Trump’s MFN policy. It is one of their deepest concerns right now when it comes to the European pharma market.”

The silence has a straightforward explanation. The likely remedies are unpopular, and everyone involved knows it:

“The possible solutions will be very unpopular. Higher medicine prices would be very unpopular among politicians, patients and, of course, voters.”

There is a second reason the industry stays quiet. Admitting to delayed launches means admitting that companies prefer the more lucrative American market, and that invites criticism from the European patients left waiting for treatments.

Pfizer’s warning and the pull of the US market

The tension broke into the open when a senior Pfizer executive said the company would choose the US over Europe if forced to pick. Frendesen reads the remark as candid rather than reckless:

“I think it might be a controversial statement, but it’s also a statement that a lot of people within the pharma industry agree with quietly.”

For many companies the arithmetic is simple. Surveys of small and mid-sized pharma firms show the American market is by far their most important export destination. Losing US access, or accepting sharply lower US prices, would force deep cuts. The Pfizer statement is also a warning to European governments, Frendesen argues: without structural change to how prices are set, more companies will choose the US.

Brussels is watching, not acting

Inside the European Commission, the response has been cautious. Pricing and reimbursement sit with national governments, not Brussels, which leaves the Commission with little room to move. Publicly the Commission has repeated a single line: it is monitoring the situation and will act if the MFN drug pricing policy starts affecting European patients or the European market. Frendesen argues those signs are already visible. He suggests the Commission is also wary of provoking the Trump administration, which has shown it will threaten retaliation when challenged.

The Critical Medicines Act is a first step

The EU’s Critical Medicines Act, recently agreed, is meant to support European production, but Frendesen is measured about what it will achieve. He said: “The final compromise was less ambitious than the Parliament’s proposal.” Where the original push centred on the lowest prices, the agreed text adds criteria around resilience and supply security. The open question is whether those criteria are binding or optional, and whether the legislation carries enough funding to make companies invest in European manufacturing. Without money attached, Frendesen notes, the incentives may not be enough.

A change that could outlast the Trump presidency

The sobering part of the conversation is Frendesen’s argument that this is not a passing problem. US medicine prices run three to four times higher than in Europe, and that is not sustainable for American patients either. The next US administration, of either party, will face the same pressure to bring prices down. He points to the EU’s Biotech Act as a case in point. The Commission’s own estimates for the Act assume a stable global market, and Frendesen reads those numbers as an admission that a significant MFN effect would shrink the Act’s impact in Europe. One detail stayed with him: a Danish patient organisation, usually the last to call for higher prices, told him it would accept a short-term increase to keep access to new medicines. He treats that as a clear sign of how deep the worry runs.

For Frendesen, the one decision Europe should take in the next 12 months is to start talking openly about the trade-offs. Every solution carries real downsides, and a public debate on the impact of MFN and the options available is the necessary first move.

Source: Pharma Minds, “Europe’s Access Dilemma” (1/5)