Insmed is delaying the launch of its inflammatory lung disease drug Brinsupri in Europe, despite receiving approval last November, due to ongoing questions about President Donald Trump’s Most Favored Nation (MFN) drug pricing initiative, according to an April 1 report. The company is not alone in reconsidering global launch strategies as a result of the policy, with other biopharma firms also evaluating their approaches.
The MFN policy aims to tie U.S. drug prices to those paid in other countries, which has led companies like Ligand Pharmaceuticals and United Therapeutics to rethink their strategies outside the United States. Matthew Majewski, vice president at Charles River Associates (CRA), said that multiple companies have asked his team whether they should proceed with launches in the European Union and other markets referenced by MFN.
Majewski explained that some companies are considering limiting product launches only to markets where higher prices can be charged. However, Eva Marchese, also a vice president at CRA, noted that new EU pharmaceutical regulations could prevent this selective approach by linking U.S. prices not just to higher-paying countries like Germany but also lower-priced ones such as the Czech Republic and Spain. A Centers for Medicare & Medicaid Services assessment found Germany’s purchasing power is 83% of that of the U.S., while it drops to 64% in both the Czech Republic and Spain.
If the Trump administration moves forward with MFN models, drugmakers may need either to accept lower U.S. prices or persuade reference countries abroad to pay more for medicines—or restrict where they launch new drugs altogether. Majewski described this situation as a “game of chicken,” saying that unless there is compromise from either side some drugs might not reach Europe "in the short-ish term." Nerea Blanqué-Catalina from Alira Health suggested this could lead to different standards of care between Europe and America.
Experts are also considering whether Chinese biotech firms could fill gaps left if Western companies avoid launching drugs overseas or set prohibitively high prices abroad. Allistair Booth from Pinsent Masons said Chinese biotechs "are very well placed to take advantage of any market anomalies MFN creates," citing lower development costs as an advantage.
Looking ahead, experts predict that a U.S.-only strategy may dominate for now but warn this could leave European patients without access to novel treatments for several years. "U.S. prices need to come down, and European prices need to come up a little bit in order to meet this happy medium," Majewski said. "Long term, there’s hope for the future that we’ll figure it out."
