Presentation (CTI)

OBJECTIVES: Recent discussions surrounding Most-Favoured-Nation (MFN) drug pricing policies in the US have raised concerns on implications for global pharmaceutical pricing, launch sequencing, and patient access to innovative medicines. This study explored how former European payers perceive the potential impact of MFN-related developments on national decision-making and market access.
METHODS: Qualitative feedback was collected from ex-payers in several countries using a structured survey. The survey explored the current influence of US MFN discussions on national decision-making, future policy changes, and whether manufacturers had cited MFN considerations during pricing or reimbursement discussions. Responses were analysed thematically to identify common perspectives and areas of divergence.
RESULTS: Respondents reported limited direct influence of US MFN discussions on current national HTA and reimbursement decision-making. Ex-payers in Sweden and Spain indicated that the US market is not currently considered in pricing reference and that no policy changes (other than those already in development) are anticipated. Italian respondents reported that despite no formal regulatory changes, MFN is already shaping pricing, particularly managing uncertainty for promising therapies, with growing expectations for risk-sharing agreements, including managed entry agreements and outcomes-based models for drugs. UK respondents highlighted that MFN-related considerations have already influenced policy discussions, citing recent adjustments to cost-effectiveness thresholds, and concerns regarding increasing manufacturer non-submissions to NICE. Across countries, respondents anticipated that manufacturers may increasingly prioritise launches and pricing strategies based on global pricing interdependencies.
CONCLUSIONS: Although US MFN policies have not yet resulted in substantial changes to European pricing and reimbursement frameworks, respondents perceive emerging effects on manufacturer behaviour, negotiation strategies, and policy discussions. Recent developments in Germany, Sweden and Japan suggest MFN-related pressure is beginning to influence policies in these regions. European payers are likely to place increasing emphasis on robust value assessment, innovative payment mechanisms, and cross-country collaboration as part of wider affordability pressures rather than MFN-specific consequences.