Presentation (CTI)

OBJECTIVES: In Czechia, pharmaceutical list prices are set as the average of the three lowest list prices across an 18-country European reference basket, often yielding prices substantially below those in the United States (US). In 2025, the US administration announced a Most-Favored-Nation (MFN) pricing initiative to align US drug prices with the lowest prices in comparable countries. The Centers for Medicare & Medicaid Services subsequently introduced the GLOBE and GUARD models, which reference prices from 19 OECD countries, including Czechia. Although US-focused, MFN policies may affect global pricing and launch incentives, particularly in lower-priced markets. This study assessed whether Czechia’s pricing framework could increase the risk of delayed or withdrawn launches of innovative medicines.
METHODS: New molecules that obtained a list price and/or official reimbursement in Czechia in 2025 were identified. Products with previously reimbursed indications were excluded. Czech list prices were compared with prices available as of June 2026 in the other 18 reference countries. Prices were ranked and adjusted for gross domestic product per capita purchasing power parity (GDP-PPP), consistent with MFN methodology, to reflect economic comparability.
RESULTS: Twenty-four drugs met the inclusion criteria. The median Czech price rank was 10 (range: 4-18; 1=lowest price). After GDP-PPP adjustment (factor: 1.498), Czech prices remained below the US benchmark for 19 products. On average, GDP-adjusted Czech list prices were 17% lower than corresponding US prices. The countries most frequently recording the lowest prices were the Netherlands (7 products), Germany (6), and Switzerland (4).
CONCLUSIONS: Prices for recently reimbursed drugs in Czechia were generally not among the lowest in MFN reference countries. Therefore, the risk that Czech launches would be delayed solely to avoid affecting US reference prices appears limited. However, given Czechia’s inclusion in MFN reference baskets and its relatively small market size, risk-sensitive manufacturers may still adopt more cautious launch strategies.