MANAGING MFN UNCERTAINTY: EUROPEAN RESPONSES AND IMPLICATIONS FOR PRICING AND ACCESS STRATEGY
Author(s)
Olof Mogard, MSc1, Elisa Tutulea, MSc2.
1Parexel International, Zürich, Switzerland, 2Parexel International, Bucharest, Romania.
1Parexel International, Zürich, Switzerland, 2Parexel International, Bucharest, Romania.
OBJECTIVES: The “Most Favored Nation” (MFN) policy may shift global pharmaceutical pricing dynamics. This study assesses early reactions from affected European Economic Area (EEA) countries and explores potential spillover effects beyond directly referenced markets.
METHODS: (1) Stakeholder responses in EEA countries above the MFN GDP threshold (≥60% of US) were assessed through targeted review of public sources to identify policy positions, perceived risks, and mitigation strategies. (2) Hypothetical scenarios explored how MFN-driven price changes in Germany, France, Italy, Sweden, and Denmark (referenced in the MFN models and EEA traditional reference pricing systems) could affect pricing in EEA countries above and below the GDP threshold.
RESULTS: (1) Most EEA countries within the MFN GDP threshold have expressed concern about potential impacts on pricing autonomy, with 141-8 of 17 issuing public positions. These primarily emphasise protecting national pricing systems and negotiation leverage. Ten countries advocate coordinated EU-level action to preserve negotiation leverage1,4-7, while three pursue national strategies3,8,9. Examples include Denmark’s task force assessing MFN-related risks³, Sweden’s review of future pricing reforms⁸, and Italy’s intent to strengthen direct negotiations⁹. Italy and Germany have also introduced measures on price confidentiality and confidential discounts10,11.(2) Scenario analysis suggests MFN-related dynamics may create bidirectional (upward/downward) pricing effects as a direct (17/28 scenarios) or indirect (10/28 scenarios) consequence of price changes in the selected five MFN-referenced countries, impacting both EEA countries above or below the MFN GDP threshold.
CONCLUSIONS: MFN interplay with traditional reference pricing systems and EEA efforts to preserve pricing autonomy and negotiation leverage may fundamentally reshape pricing corridors. European countries are increasingly aligning their stance and coordinating responses to limit spillovers and prevent destabilisation of pricing systems. However, tangible reforms remain limited, with actions largely confined to signalling and early-stage initiatives. For manufacturers, advanced cross-country modelling will be key to address uncertainties.
METHODS: (1) Stakeholder responses in EEA countries above the MFN GDP threshold (≥60% of US) were assessed through targeted review of public sources to identify policy positions, perceived risks, and mitigation strategies. (2) Hypothetical scenarios explored how MFN-driven price changes in Germany, France, Italy, Sweden, and Denmark (referenced in the MFN models and EEA traditional reference pricing systems) could affect pricing in EEA countries above and below the GDP threshold.
RESULTS: (1) Most EEA countries within the MFN GDP threshold have expressed concern about potential impacts on pricing autonomy, with 141-8 of 17 issuing public positions. These primarily emphasise protecting national pricing systems and negotiation leverage. Ten countries advocate coordinated EU-level action to preserve negotiation leverage1,4-7, while three pursue national strategies3,8,9. Examples include Denmark’s task force assessing MFN-related risks³, Sweden’s review of future pricing reforms⁸, and Italy’s intent to strengthen direct negotiations⁹. Italy and Germany have also introduced measures on price confidentiality and confidential discounts10,11.(2) Scenario analysis suggests MFN-related dynamics may create bidirectional (upward/downward) pricing effects as a direct (17/28 scenarios) or indirect (10/28 scenarios) consequence of price changes in the selected five MFN-referenced countries, impacting both EEA countries above or below the MFN GDP threshold.
CONCLUSIONS: MFN interplay with traditional reference pricing systems and EEA efforts to preserve pricing autonomy and negotiation leverage may fundamentally reshape pricing corridors. European countries are increasingly aligning their stance and coordinating responses to limit spillovers and prevent destabilisation of pricing systems. However, tangible reforms remain limited, with actions largely confined to signalling and early-stage initiatives. For manufacturers, advanced cross-country modelling will be key to address uncertainties.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR213
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Pricing Policy & Schemes, Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas