Presentation (CTI)

OBJECTIVES: The impact of MFN agreements on European launches remains unclear; while emerging signals show reduced and/or delayed launches, establishing if MFN specifically drives these changes is difficult. This research characterizes MFN agreements to date, systematically assesses pricing and launch spillover effects attributed to MFN, and explores future implications for Europe.
METHODS: A structured review of public websites (White House, Centers for Medicare & Medicaid Services, TrumpRx, manufacturer press releases) identified MFN agreement details as of June, 1 2026. Targeted web searches were conducted to determine MFN-linked pricing and launch spillover effects.
RESULTS: Seventeen MFN deals have been announced. Core commitments are: (a) MFN-aligned Medicaid pricing (only for certain medicines; n=4 manufacturers); (b) MFN-aligned future launch pricing (excluding the commercial channel; n=1); (c) repatriating revenue by negotiating higher ex-US prices; (d) direct-to-consumer channel participation (74 branded products on TrumpRx, with 10-95% price discounts); and (e) investment in US research and development (~$450 billion). Additional provisions include donations of active pharmaceutical ingredients (n=3) and free-of-charge product access for specific US patients (n=1), suggesting increasing deal flexibility and US price reductions that will likely be recouped elsewhere. Eight MFN-attributed spillover events were identified: (a) pricing spillovers (n=4), comprising US list-price reductions alongside ex-US increases (n=2), equal US-UK prices (n=1) and leveraging of MFN dialogue to secure favourable pricing during negotiations (n=1); and (b) launch spillovers (n=4), comprising product withdrawals (n=1), paused/delayed global launch programmes (n=1) and delayed/withdrawn launches in markets (unspecified products; n=2).
CONCLUSIONS: MFN agreements are influencing ex-US pricing and launch strategies; however, MFN attribution remains constrained by limited public disclosure and confounding factors. These findings highlight the importance of monitoring evolving deal structures and spillover dynamics to ensure European preparedness in a post-MFN world. Future research should quantify MFN impacts on reimbursement status and timing in ex-US markets.