Pfizer CEO Albert Bourla’s discussion at the June 2025 Goldman Sachs Healthcare conference centered on Pfizer conference insights regarding the pharmaceutical industry’s evolving policy landscape, strategic priorities, and responses to regulatory challenges. The conversation highlighted critical developments related to the Trump administration’s Most-Favored-Nation (MFN) drug pricing executive order. It also covered U.S.-led efforts to realign global drug pricing and Pfizer’s operational adjustments amid geopolitical and market pressures. Bourla emphasized opportunities for regulatory reform, such as PBM restructuring and 340B program fixes. He also outlined Pfizer’s pipeline strategy, cost-control initiatives, and capital allocation priorities, including maintaining dividends while pursuing disciplined M&A.

Strategic Implications of the MFN Executive Order

Policy Framework and Industry Concerns

The May 2025 MFN executive order mandates that U.S. drug prices align with the lowest prices in OECD countries with GDP per capita ≥60% of the U.S., such as Germany and the UK. Bourla characterized this as a “radical change” with dual risks: downward pressure on U.S. prices and uncertain trade negotiations to raise international prices. The administration’s bifurcated approach reflects an unprecedented U.S. stance against “free-riding” on drug innovation.

Comparative Spending and Access Dynamics

Bourla mentioned that he U.S. spends 0.8% of GDP on innovative medicines versus 0.4% in Germany and 0.5% in Spain and Italy. He argued that European price controls limit access, as only 43% of EMA-approved drugs receive reimbursement compared to broader U.S. availability. Bourla suggested MFN-driven U.S. price cuts could improve affordability if paired with expanded access.

Geopolitical Pricing Negotiations

The U.S. is leveraging trade talks to demand higher drug spending from allies, analogous to NATO defense budgeting. The UK recently agreed to increase pharmaceutical expenditures, serving as a model for potential EU negotiations. Bourla proposed tying national drug spending to GDP percentages, which could pressure Europe to relax clawbacks and rebates. However, such measures face political resistance.

Tariffs and Supply Chain Resilience

Impact on API Sourcing and Manufacturing

Bourla noted Pfizer’s 11 U.S. manufacturing sites provide flexibility to shift production domestically. This contrasts with other companies, which face $200M in added costs from Canada/Mexico tariffs. However, Bourla warned that prolonged tariffs could deter resilience investments.

Pfizer’s $1.7B cost-cutting program emphasizes AI-driven R&D efficiency and manufacturing automation. Bourla linked these measures to margin expansion despite MFN/tariff headwinds.

Health Economics and Outcomes Considerations

Bourla highlighted Pfizer’s PD-1/VEGF bispecific as a disruptor in immuno-oncology. The asset’s synergy with Pfizer’s ADC portfolio aims to counter Keytruda’s dominance. He also emphasized ELREXFIO’s potential in earlier-line multiple myeloma.

The MFN model creates a tension between U.S. affordability and global innovation funding. While 30–80% U.S. price reductions are expected, strict international alignment could reduce R&D investment.

Bourla argued that lower U.S. prices paired with reduced abandonment could offset revenue losses. However, mandatory price negotiations under the IRA have disproportionately targeted high-revenue drugs.

Conclusion: Navigating a Shifting Policy Landscape

Pfizer’s strategy reflects cautious adaptation to MFN and tariff policies, prioritizing cost control, pipeline diversification, and shareholder returns. The success of U.S.-led pricing reforms hinges on balancing domestic affordability with sustainable global innovation incentives. Key questions remain: Can volume-based access expansion offset MFN price cuts? Will GDP-linked drug spending benchmarks gain international traction? And how will tariff-driven supply chain reshoring affect long-term drug costs? As Bourla noted, the industry’s depressed valuations signal investor skepticism. For a detailed understanding of Bourla’s remarks and their implications, refer to the transcript.