Presentation (CTI)

OBJECTIVES: Global pharmaceutical markets are undergoing a reset in response to U.S. pricing reforms—particularly international reference pricing under the Most Favoured Nation (MFN) policy— which reshape incentives for innovation, pricing, and access. Although U.S.-focused, these reforms have significant global spillover effects. This research examines how U.S. pharmaceutical pricing policy influences international markets, innovation incentives, and patient access, and identifies evidence-based pathways toward more sustainable and equitable global value models. Heightened political momentum around cost containment and inflationary pressures make these dynamics both policy relevant and urgent.
METHODS: A mixed-methods approach combines a targeted literature review, comparative policy analysis, pricing and access case studies across Europe and Asia, and structured engagement with key stakeholders including payers, policymakers, and industry representatives. The subsequent analysis focuses on three interconnected themes: global innovation incentives, international effects on launch sequencing and access strategies, and evolving value assessment and contracting frameworks.
RESULTS: Growing price convergence pressures are prompting governments to tighten health technology assessment and pricing processes, as seen in EU joint procurement, Japan’s repricing rules, and Canada’s PMPRB reforms. U.S. pricing reforms meanwhile reframe pharmaceutical pricing as an issue of trade, security, and fairness. Our research identifies launch delays and strategic sequencing shifts, especially in oncology and rare diseases, as manufacturers adjust global pricing strategies to manage spillover risks. Payers are increasingly adopting outcomes-based agreements and risk-sharing models to balance affordability with timely access.
CONCLUSIONS: U.S. pricing reforms are altering global power dynamics among policymakers, payers, and manufacturers, with profound implications for innovation and access. This research underscores the need to view pharmaceutical spending as an investment in health and economic value and to develop coordinated, forward-looking policies. International dialogue will be critical to prevent fragmentation and safeguard both innovation and equitable access in an evolving global pricing landscape.