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US President Trump has promised to bring down US drug prices to the same levels as in other wealthy countries. <\/p>\n
Keystone-SDA <\/p>\n
The US president\u2019s Most Favoured Nation drug-pricing policy has triggered an earthquake across Europe as pharmaceutical giants scramble to protect their bottom lines.\n<\/p>\n
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March 20, 2026 – 09:00\n<\/p>\n
As the first anniversary of Donald Trump\u2019s Most Favoured Nation (MFN) drug-pricing executive orderExternal link<\/a> approaches, the policy, which is aimed at cutting US healthcare costs, is no longer just a protectionist threat on paper. The order, which effectively forces pharmaceutical companies to charge US consumers the same as in other wealthy countries, has started to gain teeth.<\/p>\n \n More<\/p>\n More <\/p>\n Healthcare innovation\n <\/p>\n Swiss pharma\u2019s global success meets worries at home <\/p>\n This content was published on <\/p>\n Feb 13, 2026 <\/p>\n Switzerland\u2019s two biggest pharmaceutical companies are doing well. Why is the country so worried? <\/p>\n <\/p>\n Read more: Swiss pharma\u2019s global success meets worries at home Some 16 drug companies, including Swiss pharma giants Novartis and Roche (through its US subsidiary Genentech), have now signed confidential MFN dealsExternal link<\/a> with the US government exempting them from tariffs for three years according to some sourcesExternal link<\/a>. As part of the deals, companies commit to align prices for new drugs with the lowest prices in a set of reference countriesExternal link<\/a>, which includes Switzerland. Some also agreed to boost investment in US research and manufacturing. In the past year, pharma companies have committed to investExternal link<\/a> in total more than $320 billion (CHF250 billion) in the US.<\/p>\n The Trump administration is also moving beyond voluntary deals to formalise MFN pricing via three models for state-run Medicaid and Medicare insurance schemes, with each using a slightly different set of reference countries. The launch of the prescription drug website TrumpRx.gov\u00a0in\u00a0February, which intends to deliver MFN prices directly to US consumers, has also raised the stakes. If companies don\u2019t offer the lowest price, they risk being left off the high-profile platform.<\/p>\n In response, some companies have said they will delay or not launch new drugs at all in European countries, where historically prices have been far lower than in America, preferring to lose an entire market than set a low price that could gut their US revenue. Others have warned they will cut research and development spending in Europe unless governments raise the amount they are willing to pay.<\/p>\n High-stakes battle<\/p>\n Although there are still major uncertainties over how MFN will be implemented, Europe must take the policy seriously, experts say.\u00a0<\/p>\n \u201cMFN is here for the long-term\u201d, said James Whitehouse, from UK-based consultants Lightning Health. \u201cUS politics are now dictating domestic health policy in other countries,\u201d Whitehouse told Europe\u2019s largest gathering of drug-pricing experts, the Evidence, Pricing and Access Congress in Amsterdam, in early March. This will have far-reaching implications for Europe, he told Swissinfo.<\/p>\n The US holds considerable sway over commercial decisions, accounting for at least half the revenue for most large pharmaceutical companies, partly due to high prices which, for branded products, can be four times higherExternal link<\/a> than in other industrialised countries.<\/p>\n Lower prices in the US would significantly cut into revenue and profit, analysts at Swiss bank UBS wrote in a report published in May 2025. They estimated that major pharma firms could suffer an 8% hit to their net profit in 2028 based on the top 50 drugs sold through Medicare in 2024 and on ten new drugs expected to become top-selling drugs by the end of the decade.<\/p>\n Pharmaceutical companies and industry groups are now painting a dire picture of worsening access to medicine and less investment in Europe if drug prices in the region don\u2019t rise to make up for lost revenue from the US.<\/p>\n US-based drug giant Pfizer, among the world\u2019s top three pharma companies by sales, was the first to sign an MFN deal. Its chief executive, Albert Bourla, told the JPMorgan Chase healthcare conference in JanuaryExternal link<\/a> that, if given a choice between reducing US prices to France\u2019s level or stop supplying France, \u201cwe [will] stop supplying France\u201d.<\/p>\n \n More<\/p>\n More <\/p>\n Drug pricing\n <\/p>\n The art of the deal: what are Trump\u2019s pharma announcements really worth? <\/p>\n This content was published on <\/p>\n Feb 18, 2026 <\/p>\n Big Pharma announced a series of groundbreaking agreements with the White House in 2025. But how much of it is just for show? <\/p>\n <\/p>\n Read more: The art of the deal: what are Trump\u2019s pharma announcements really worth? In contrast to the US where drug prices are largely based on market forces, European governments typically set prices through negotiation with companies. However, these have become more contentious, as companies argue prices aren\u2019t adequately rewarding innovation. This is echoed by Trump who claims\u00a0Europe is\u00a0\u201cfreeloading\u201d on\u00a0innovation financed by US patients.<\/p>\n \u201cEven before MFN was announced, the industry had been highly critical of the pricing environment in Europe, arguing it fails to recognise value,\u201d said Neil Grubert, a UK-based global market access consultant. Europe has already seen its share of global R&D\u00a0investment\u00a0fall relative to the US and China. \u201cPressure is now also being exerted on European governments by President Trump.\u201d<\/p>\n The stakes are particularly high for small, wealthy reference countries such as Switzerland and Denmark, whose economies depend heavily on the pharmaceutical sector but have less market leverage.<\/p>\n Last July Roche pulled its cancer drug Lunsumio from Switzerland\u2019s list of reimbursed drugs<\/a> after talks broke down with the federal public health office over the cost. Patients can still access the drug through a special charity programme, but the drug and its price are not published on the reimbursement list. A Roche spokesperson told Swissinfo that the withdrawal of Lunsumio in Switzerland is\u00a0unrelated to US policies.<\/p>\n \n More<\/p>\n More <\/p>\n Drug pricing\n <\/p>\n How a clash with Roche exposed cracks in Swiss drug pricing system <\/p>\n This content was published on <\/p>\n Sep 19, 2025 <\/p>\n Switzerland\u2019s new process to speed up patient access to the latest drugs hit its first major hurdle in a clash with Roche. <\/p>\n <\/p>\n Read more: How a clash with Roche exposed cracks in Swiss drug pricing system US biotech firm Amgen, one of the companies that signed an MFN deal, recently withdrew its cholesterol-lowering drug Repatha from the Danish market, citing changed \u201cglobal market dynamics\u201d \u2013 although local mediaExternal link<\/a> speculated the withdrawal was due to MFN pressure. Amgen lowered the drug\u2019s price by 60% in the US in October 2025 to what it saidExternal link<\/a> was the lowest among economically developed (G7) countries.<\/p>\n \u201cSome companies are saying the rational thing to do is to not launch an innovative drug in other countries until you have secured a US price to avoid pulling down the US price,\u201d said Elisabeth Brock, a health economist and market access consultant based in Basel. \u201cIf you have no price, the US has nothing to compare to.\u201d<\/p>\n Austerity bites<\/p>\n While Trump exerts pressure from across the Atlantic, European governments face domestic constraints that make price increases difficult. Many healthcare authorities, including those in Switzerland and Germany, are trying to rein in costs that have skyrocketed over the past decade.<\/p>\n Spending on medicineExternal link<\/a> by Switzerland\u2019s basic insurance hit a record CHF9.4 billion ($12 billion) in 2024, a 64% jump from 2014, driven by a handful of new, expensive treatments.<\/p>\n Some of these are true, life-changing innovations but not always. Studies<\/a> have found that for some cancer drugs higher prices don\u2019t necessarily correspond with more clinical benefit to patients.<\/p>\n This has led countries to demand greater justification for prices.\u00a0Most European countries now require Health Technology Assessments to evaluate a drug\u2019s cost-effectiveness. Some drugs, widely available in the US, have been rejected by some European price regulators because the assessments found the drug\u2019s benefits didn\u2019t justify their costs.<\/p>\n \u201cPharmaceutical companies say they need higher prices, but in Europe they need to prove that the drug is worth it,\u201d said Brock. This price-setting approach also makes it difficult for European governments to raise prices with the flip of a switch, especially in the face of public pressure.<\/p>\n![\"buildings](\"https:\/\/www.europesays.com\/ch\/wp-content\/uploads\/2026\/05\/691583573_highres.jpg\")
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