Author: Steve Glass , Group Chief Executive Officer
This week, President Donald Trump signed a sweeping executive order that has quickly re-ignited global debate on drug pricing. At the heart of this policy is a simple but bold idea: the United States should not pay more for prescription drugs than any other developed country a so-called “Most Favoured Nation” (MFN) pricing model.
As a consultancy supporting pharmaceutical and biotech clients in navigating European market access, we’re closely watching how this development might ripple across global pricing and reimbursement strategies.
What’s in the Executive Order?
The executive order, titled “Delivering Most-Favoured-Nation Prescription Drug Pricing to American Patients”, mandates that U.S. drug prices be pegged to the lowest prices paid in other wealthy nations. It introduces a 30-day window for manufacturers to voluntarily reduce prices and opens the door to more aggressive measures like international drug importation and direct-to-consumer sales at MFN prices.
Why This Matters to European Market Access Teams
At first glance, this may seem like a U.S. centric policy, but its implications will be felt globally especially in Europe, which is often used as a pricing benchmark.
Here are three key takeaways for those operating in or entering the European market:
1. Europe is Now a Reference Market — in More Ways Than One
Traditionally, Europe has used external reference pricing (ERP) often looking to neighbouring countries to cap drug prices. Now, with the U.S. aligning to European prices, Europe effectively becomes the global pricing floor. This may increase pressure from both U.S. policymakers and multinational manufacturers to adjust European launch prices upward to preserve global revenue potential.
2. Global Launch Sequencing Will Get More Strategic
Pharma companies may reconsider where and when they launch new therapies. If U.S. reimbursement becomes tied to European prices, early launches in low-price markets could jeopardise pricing potential in the U.S. We expect to see more selective launch sequencing and a renewed focus on market access optimisation, especially in lower-price countries like Spain, Greece, and parts of Eastern Europe.
3. Value Communication and HTA Alignment Are Critical
With growing international scrutiny, how a drug’s value is demonstrated to European health technology assessment (HTA) bodies will have greater downstream impact. The ability to secure premium reimbursement in high-price European markets (e.g., Germany, Sweden) will become an even more critical component of global pricing strategies.
What Comes Next?
While legal and implementation challenges may stall or reshape this policy in the U.S., the message is clear: the days of the U.S. absorbing global drug development costs through higher prices may be ending. For pharmaceutical manufacturers and biotech innovators, this underscores the need for coordinated global pricing strategy, one that anticipates political shifts, aligns market access evidence generation, and navigates a growing web of interdependent pricing systems.
At Kintiga we’re working with clients across the globe to adapt to this new reality, from launch sequencing to local payer engagement and cross-border pricing risk mitigation.
In Closing
Trump’s MFN executive order may not be the final word on U.S. drug pricing, but it is a clear signal of where the conversation is heading. For European access teams, the spotlight is brighter than ever. And for all of us in pharma and biotech, the challenge, and opportunity, lies in shaping access strategies that are not only responsive, but resilient.
