"Europe's Access Dilemma" (1/5) - Europe Is Losing Access to New Medicines. Here’s Why.

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I've spoken to pharma leaders and many people from within the industry and they are all very concerned about

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Trump's MFN policy.

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It is one of their deepest concerns right now when it comes to the...

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European pharma market.

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When the CEO of Pfizer says publicly if we have to choose between Europe and the US,

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we already choose,

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we go to the US.

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Do you think it's an announcement?

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Delayed launches is something that we already see,

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so the changes and the effects on

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European patients are already there.

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There are some topics that nobody wants to talk about in formal.

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Topics that make executives uncomfortable,

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paralyze the government,

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and yet directly impact

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European patients.

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We have Trump's

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MFN policy,

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which is one of them,

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but we have also

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Europe's vision for innovation.

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And

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I'm really happy to be here today with Christophe Rannissen.

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Hello,

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Christophe.

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Hello.

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You are a pharma journalist in Brussels,

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specialized in pricing and market access policies,

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and maybe one of the few who can speak freely about

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MFN because it's not constrained by commercial interest.

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I can bring maybe a few points of context.

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We have Trump instituted the MFN,

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Most Favored

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Nation Policy,

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which is the drug prices in the U.S.

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that cannot exceed those in other developed countries.

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including several European countries.

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And the immediate consequence is the pharma industry fears launching some innovation in Europe at low prices or delay some launches as they will drag their prices in the US down.

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And then

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I'm happy to have you here today.

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The premise of this episode is maybe to explain why everyone is silent on this topic.

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What the real story is.

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stakes are and maybe above all,

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what options

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Europe has in the middle of this.

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Christopher,

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you told me that you've spoken to many leaders or institutions about this topic,

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about this policy.

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Can you tell me maybe what strikes you the most about the reactions?

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First of all,

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thank you very much for inviting me to this podcast.

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It is,

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as you already hinted at,

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a very interesting topic and it's a very hot topic right now in Europe and also in many other places of the world I believe and as you also mentioned that there is not there hasn't been the people

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haven't really thrown themselves against each other to be able to talk about this publicly but it is something that I know that is a very concerning topic for many behind closed doors

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As you said,

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I've spoken to pharma leaders and many people from within the industry,

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and they are all very concerned about

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Trump's MFN policy.

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It is one of their deepest concerns right now when it comes to the European pharma market.

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Why are they concerned and why at the same time don't they want to talk about it?

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That has been very interesting to me.

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I think a lot of them want political action at this point.

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but no one agrees on the potential treatment to counter Trump's MFN policy.

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So there is a lot of uncertainty there.

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I would speculate that one of the reasons why so few people want to speak about it is that the possible solutions will be very unpopular.

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Some of the solutions,

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which we'll also go into,

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I'm sure,

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further down the road,

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could be higher prices,

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higher medicine prices,

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which would be very unpopular among politicians,

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patients,

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and of course,

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voters.

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So

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I think for that reason,

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it's not something that either politicians or pharma companies want to talk too much about.

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Okay,

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interesting.

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And if you talk to the facts beyond the silence,

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because it's been nearly one year we're talking about this,

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and what's the concrete evidence that

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MFN policy is already impacting Europe,

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even if nothing is really clear?

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Well,

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one of the signs was...

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recent analysis of some data of new medicine being launched in Europe.

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The data was pretty clear that there were delays.

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In Europe,

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like for some countries more than others,

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countries that has been selected as reference countries for

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Trump's MFN policy within the US are affected more than other European countries.

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But nonetheless,

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the figure speaks for themselves.

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Like the amount of fewer launches have been significant.

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I think it's from between 35%

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for some European countries up to above 40%

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for some European countries.

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so the

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The change in medicines that are delayed or not launched at the European market is very,

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very significant.

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And that's also one of the reasons why some companies might don't want to talk about it,

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because one thing is for them to talk about higher medicine prices.

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That is not popular.

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Another thing is for pharma companies to talk about possibly delaying the launches of new medicines in Europe.

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That is also going to be vulnerable to criticism because essentially it's implying that

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they prefer to launch on the American market,

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which is much more lucrative.

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But on the other side,

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they want to delay launches or not launch immediately in Europe because that might affect the profits that they can make on the American market.

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So European patients might not be filled with that information.

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So that's also one of the reasons why they maybe don't want to talk about it too much.

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Okay,

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then if it's not public,

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what is the state?

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What can be the option,

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how we can tackle this thing?

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How can we open the problem?

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That's a very,

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very good question.

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I don't think there's any clear answers to this at this point.

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And there could also be,

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I think there might also be multiple solutions needed.

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One thing that has been talked about is integration,

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European integration within the European Union.

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So that would mean closer cooperation or more streamlined

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European processes instead of separate national processes.

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But this is very controversial.

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This is not something that is in the cards right now.

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But it is some of the solutions being talked up,

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at least among people in the European Parliament.

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I think if you talk on behalf of a

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EU country,

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your perspective might be a bit different,

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I would argue.

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There are some

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Current proposals on the table,

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the Critical Medicines Act and also other legislations that are passing their way through the EU law machine.

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But I think we'll touch on them a bit later.

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OK,

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I just go back a bit to the unpopular situations.

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Then when the CEO of Pfizer says publicly,

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if we have to choose between Europe and the US,

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we already choose.

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We go to the US.

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Do you think it's a...

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It's an announcement.

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How do you read it?

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It would be very interesting to hear his conversation with other people within Pfizer just before he went on stage and said this,

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just to hear what was his thoughts about it.

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Because

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I think it might be a controversial statement,

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but I think it's also a statement that a lot of people within the pharma industry agrees with quietly.

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I think that because the American market is so lucrative,

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because it is such a big part of the profit that some companies are making.

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Some companies are really dependent on exporting to the U.S.

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market.

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There were surveys among smaller and medium-sized pharma entrepreneurs,

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and for them,

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by far,

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the American market is the most important export market for them.

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So the U.S.

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market is so...

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economically beneficial that if they would lose access to the US market or if they would have to cut their prices substantially,

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these businesses would likely face massive cuts and changes if they were to lose access to the American market,

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or as I said,

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accept lower prices.

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So I think the message from the

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Pfizer CEO was a clear signal that if they are forced to decide between the US and other countries,

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many companies...

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will choose the US just because that is more profitable to them.

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And they might be dependent on that for further developing new products,

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which is hugely important within the medicine market.

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I think it's also a signal to European countries and European nations that if they don't introduce major structural changes to how prices are set in Europe,

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or if prices are not increased in Europe,

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then a lot of companies will choose the US in these circumstances.

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So I think it's a warning sign also for European nations that something has to give.

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Yes,

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because it's indeed the...

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The European

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CEO, he's from Europe.

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And if we talk about the European Commission,

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because you're also really close to this institution,

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what do you think the institution is about this?

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Do they understand they would have to do something or prefer to wait?

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What is your feeling on this?

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Is there differences also inside the European Commission?

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I would imagine there is.

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I'm not

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I'm not too familiar with the potential difference of opinions within the commission,

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but usually the different DGs under the commission have different approaches.

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So if it's the trade part of the commission,

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the trade DG,

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they might have a different view on this than the health and pharma DG,

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you could say.

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But overall,

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the commission's hands are sort of tied.

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National

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Or health is,

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or rather health is a national competence,

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especially pricing and reimbursement decisions,

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which are done at national level today.

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And will probably continue that way for a long time.

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And one of the solutions that come up when you talk about MFN and what the European countries can do or the EU can do,

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then a lot of it circles around pricing and reimbursement,

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which are,

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as I said,

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national competence,

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national decisions.

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So that would be hard for the commission to really do anything about.

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It will be a national decision and the commission can't really force the countries to do a lot of stuff on pricing and reimbursement.

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Also,

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in terms of saying something publicly about the MFN situation,

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the commission has also been very hesitant.

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They've said that we are monitoring the situation and we will do something if there are beginning to be signs.

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that the MFN is affecting European patient or the European foreign market.

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I would argue that these changes are these signs of the potential consequences of the MFN are beginning to show in Europe.

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So

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I think that depending on how you choose to look at it,

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the signs are definitely there.

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But so far,

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the Commission is maintaining that it's monitoring the situation.

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It could be possible for the Commission to do like to usher a formal Thank you.

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response,

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like a comment on it.

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But I think they'll be hesitant to do that because they don't necessarily want to trigger Trump and his potential wrath that he has been.

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I think it's fair to say that he has been known that if you say something,

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if you state something that Trump doesn't like,

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he could become upset and he could start threatening you with terrorists or other threats.

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So I think the commission is very hesitant to publicly comment on this.

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And

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Could there be another formal coordination or something by the Commission?

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Yes,

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possibly.

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But so far,

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as far as I know,

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there hasn't been any sign that the Commission is beginning to draft a common response.

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Okay,

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you talked about fragmentation of Europe,

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having which is the national system of price and reimbursement.

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And do you think Europe starts to...

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It's a question we often have from different parts of the industry,

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like see Europe as a strong continent and show signs of its coordination between states.

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And do you think some movements are made in the direction to have a common voice,

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a unique voice for Europe?

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It's a very good question.

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I think for a long time,

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health will remain a national competence.

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I don't think the countries are willing at this point to give up power,

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00:14:01.745 --> 00:14:08.168
to give up decisions and leave it to the EU or a majority of countries,

259
00:14:08.508 --> 00:14:12.109
a qualified majority within the EU to decide on health issues.

260
00:14:12.489 --> 00:14:13.610
I don't think we're there yet.

261
00:14:14.310 --> 00:14:15.051
Is it necessary?

262
00:14:15.531 --> 00:14:16.551
That I don't know either.

263
00:14:17.371 --> 00:14:18.612
But I don't think at this point...

264
00:14:18.652 --> 00:14:20.393
point that the countries are willing to do it.

265
00:14:20.873 --> 00:14:22.734
There might need to be some more coordination.

266
00:14:22.774 --> 00:14:28.277
There might need to be some more cooperation within the area of health.

267
00:14:28.778 --> 00:14:32.460
But I think it's going to be incremental changes rather than big changes.

268
00:14:32.740 --> 00:14:34.000
And I think at the same time,

269
00:14:34.381 --> 00:14:40.044
for countries to respond individually to Trump's MFN pricing regime,

270
00:14:40.764 --> 00:14:41.945
I think that's going to be difficult.

271
00:14:42.205 --> 00:14:43.045
I come from Denmark.

272
00:14:43.306 --> 00:14:44.206
I grew up in Denmark.

273
00:14:44.626 --> 00:14:47.468
And for Denmark to have to deal with

274
00:14:47.712 --> 00:14:50.576
the MFN price regime and Trump individually.

275
00:14:50.657 --> 00:14:52.299
I don't think that will be easy.

276
00:14:52.459 --> 00:14:54.622
We've seen that at other times when,

277
00:14:54.803 --> 00:14:55.003
like,

278
00:14:55.004 --> 00:14:55.544
for instance...

279
00:14:56.235 --> 00:14:58.557
there was a discussion on whether or not the U.S.

280
00:14:58.577 --> 00:14:59.978
should be able to acquire Greenland.

281
00:15:00.618 --> 00:15:04.861
Denmark was quick to involve the rest of the EU and also some NATO countries,

282
00:15:04.862 --> 00:15:05.241
of course,

283
00:15:05.601 --> 00:15:07.863
because they know that they cannot do this alone.

284
00:15:08.663 --> 00:15:16.969
And what I think and what I recently heard is that I think countries are probably going to try to negotiate with Trump to get a deal,

285
00:15:17.549 --> 00:15:21.612
maybe sort of inspired by the deal that UK made with the U.S.

286
00:15:21.952 --> 00:15:25.575
and which would basically pave the way for higher medicine prices.

287
00:15:26.187 --> 00:15:32.929
I think that there is going to be an attempt by some countries to do that because when we all peel the layers of the EU back,

288
00:15:33.349 --> 00:15:45.352
we still come down to we have a lot of nation states and they will focus on their national problems and try to solve them even if it doesn't necessarily,

289
00:15:45.552 --> 00:15:49.213
even if it's come at the expense sometimes of other countries.

290
00:15:50.013 --> 00:15:53.274
They are nation states and they act egotistical sometimes.

291
00:15:53.354 --> 00:15:55.615
That is just how it is still at this point.

292
00:15:56.755 --> 00:15:57.155
Recently,

293
00:15:57.215 --> 00:16:01.737
we had some agreement on the Critical Medicines Act to support

294
00:16:02.258 --> 00:16:03.678
European production.

295
00:16:04.719 --> 00:16:07.820
How do you read this announcement in this context?

296
00:16:09.221 --> 00:16:15.223
So we still have not seen the final text of the Critical Medicines Act compromise.

297
00:16:15.683 --> 00:16:18.585
So we don't know the exact details and the exact wording,

298
00:16:18.685 --> 00:16:18.885
which,

299
00:16:18.925 --> 00:16:19.365
of course,

300
00:16:19.485 --> 00:16:21.246
is important in situations like this.

301
00:16:21.846 --> 00:16:24.187
But we do know more or less like.

302
00:16:24.347 --> 00:16:27.528
the broad strokes of what the parliament and the council have agreed on.

303
00:16:28.348 --> 00:16:31.789
The final compromise was less ambitious than the parliament's proposal.

304
00:16:32.109 --> 00:16:34.430
Instead of just focusing on getting the lowest prices,

305
00:16:34.890 --> 00:16:39.372
now you can introduce a criteria that focuses on resilience and supply security.

306
00:16:40.172 --> 00:16:40.592
However,

307
00:16:41.212 --> 00:16:50.715
we do not know if this will be enough to encourage countries or national authorities to favorize bidders that have some European production.

308
00:16:51.163 --> 00:16:54.406
Because a lot of EU countries are struggling with their economies.

309
00:16:55.026 --> 00:16:59.490
And also we have in all countries searching expenses for the health sector.

310
00:17:00.130 --> 00:17:04.714
So if all countries have to pay more for medicines to get

311
00:17:05.555 --> 00:17:09.258
European production or European ingredients for pharmaceuticals,

312
00:17:09.938 --> 00:17:11.480
maybe that's strategically smart.

313
00:17:11.560 --> 00:17:12.440
But at the same time,

314
00:17:12.541 --> 00:17:14.802
the state coffers don't necessarily allow it.

315
00:17:15.343 --> 00:17:16.063
And therefore,

316
00:17:16.064 --> 00:17:17.645
the wording is very important.

317
00:17:19.266 --> 00:17:19.466
Thus,

318
00:17:19.566 --> 00:17:20.167
member states...

319
00:17:20.491 --> 00:17:20.931
Absolutely.

320
00:17:21.431 --> 00:17:27.114
Are they obliged to include these criteria of resilience and supply security?

321
00:17:27.634 --> 00:17:29.955
Or is it an option for them to choose?

322
00:17:30.555 --> 00:17:39.259
This will matter a lot and whether or not it's going to make companies invest in European production and European manufacturing.

323
00:17:39.799 --> 00:17:40.679
It's not for certain.

324
00:17:41.080 --> 00:17:43.781
Also because the legislation doesn't really offer any money.

325
00:17:44.201 --> 00:17:48.203
So the money would also have to come from state coffers.

326
00:17:49.403 --> 00:17:50.044
from the EU.

327
00:17:50.264 --> 00:17:51.045
And that is also,

328
00:17:51.525 --> 00:17:52.226
as I just mentioned,

329
00:17:52.246 --> 00:17:54.628
that could also be challenging.

330
00:17:55.668 --> 00:17:56.829
So will it make a difference,

331
00:17:56.830 --> 00:17:58.010
the critical medicines act?

332
00:17:58.431 --> 00:17:59.752
It's hard to say at this point.

333
00:18:00.612 --> 00:18:04.476
One of the intentions is to boost manufacturing within the EU.

334
00:18:05.496 --> 00:18:06.097
Will it do that?

335
00:18:06.357 --> 00:18:07.098
We're not sure yet.

336
00:18:07.178 --> 00:18:10.020
It might be better than if nothing else was agreed,

337
00:18:10.500 --> 00:18:14.163
but it's not going to push it as much as the parliament wanted initially.

338
00:18:15.044 --> 00:18:18.467
It's interesting because it seems like a good signal to make.

339
00:18:18.587 --> 00:18:20.508
a strong voice or a stronger direction,

340
00:18:21.048 --> 00:18:23.029
but it's still a first step.

341
00:18:23.690 --> 00:18:25.231
And beyond policy,

342
00:18:25.511 --> 00:18:27.052
what would a stronger

343
00:18:27.652 --> 00:18:33.175
European voice would actually look like in this kind of situation?

344
00:18:33.615 --> 00:18:36.717
Do you think we should have had,

345
00:18:38.478 --> 00:18:42.980
we should have different kinds of signals which are still ignored?

346
00:18:44.441 --> 00:18:46.842
I think it's a very hard question.

347
00:18:47.543 --> 00:18:47.923
I think.

348
00:18:48.919 --> 00:18:50.320
In terms of answering,

349
00:18:50.400 --> 00:18:50.640
like,

350
00:18:50.760 --> 00:18:54.942
what should a strong European voice look like or what should it say?

351
00:18:55.062 --> 00:19:00.084
I think that's a question for somebody much smarter and with more high level influence than me.

352
00:19:00.844 --> 00:19:01.104
But

353
00:19:01.464 --> 00:19:16.290
I think one first step would be for politicians to actually talk openly about the massive problems that we might be facing because of directly because of the most very nation policies of the Trump administration.

354
00:19:16.810 --> 00:19:18.011
I think that would be a first step.

355
00:19:18.467 --> 00:19:22.068
I think for a lot of people that are not within the health sector,

356
00:19:22.429 --> 00:19:23.209
they are not aware,

357
00:19:23.429 --> 00:19:28.591
they are possibly not aware that we are likely facing higher prices within Europe.

358
00:19:29.251 --> 00:19:35.894
And also that medicine is actively being delayed so patients won't have access to the newest treatments.

359
00:19:36.374 --> 00:19:38.295
I think many people are not aware of that.

360
00:19:38.735 --> 00:19:47.639
And I think those discussions need to happen for solutions to surface and then for politicians to discuss.

361
00:19:48.247 --> 00:19:51.652
these potential solutions with voters and with patients.

362
00:19:52.192 --> 00:19:54.696
I think I talked about it a little bit earlier,

363
00:19:54.716 --> 00:19:57.179
but I would like to also revisit the idea that...

364
00:19:57.909 --> 00:20:00.591
that is being proposed from some members of the European Parliament.

365
00:20:01.011 --> 00:20:02.032
This idea of,

366
00:20:02.752 --> 00:20:05.394
instead of having national pricing and reimbursement decisions,

367
00:20:05.794 --> 00:20:12.819
then to have a streamlined EU reimbursement and pricing and reimbursement process.

368
00:20:13.379 --> 00:20:14.920
It is a very controversial proposal,

369
00:20:15.241 --> 00:20:16.902
but I've heard it from multiple people,

370
00:20:17.002 --> 00:20:19.163
both from people within the European Parliament,

371
00:20:19.524 --> 00:20:20.985
but also from health experts,

372
00:20:21.005 --> 00:20:25.067
that say this maybe could be a solution to the Trump MFN policy.

373
00:20:25.848 --> 00:20:27.409
One thing that it would solve is that

374
00:20:27.509 --> 00:20:30.872
We have very unequal access to medicines within the EU already today.

375
00:20:31.332 --> 00:20:38.318
Some countries have way earlier access and some countries will gain access much later if they will even get access to new medicines.

376
00:20:38.799 --> 00:20:40.900
So we have an unequal access already.

377
00:20:41.601 --> 00:20:46.385
If you have one pricing and reimbursement process within the EU instead of national,

378
00:20:46.986 --> 00:20:54.772
you could probably limit this problem because if there's just one pricing and reimbursement process,

379
00:20:55.193 --> 00:20:55.373
then...

380
00:20:55.849 --> 00:20:58.871
Medicine would be available in more countries faster.

381
00:20:59.391 --> 00:21:02.913
But the catch is that some countries would likely have to pay more.

382
00:21:03.313 --> 00:21:07.535
So the richer countries would have to pay a bigger part of the bill than the poorer countries.

383
00:21:07.976 --> 00:21:08.556
And of course,

384
00:21:08.796 --> 00:21:10.177
that is going to be difficult.

385
00:21:11.037 --> 00:21:13.899
I've talked to some people from the industry who said that,

386
00:21:14.859 --> 00:21:15.079
yes,

387
00:21:15.179 --> 00:21:17.621
we're not necessarily completely against this,

388
00:21:18.181 --> 00:21:23.304
but it would demand a high level of solidarity between EU countries.

389
00:21:23.844 --> 00:21:25.245
And that level of solidarity.

390
00:21:25.665 --> 00:21:26.586
has yet to be seen.

391
00:21:27.066 --> 00:21:31.749
So the industry are maybe not thrilled about these proposals,

392
00:21:32.330 --> 00:21:35.131
but they could be open to them.

393
00:21:35.252 --> 00:21:36.452
But at the same time,

394
00:21:36.453 --> 00:21:37.953
they also recognize that right now,

395
00:21:38.474 --> 00:21:41.336
EU countries are not very likely to pursue this path.

396
00:21:41.896 --> 00:21:44.338
Maybe if the consequence of the

397
00:21:44.718 --> 00:21:46.279
MFN becomes even worse,

398
00:21:46.979 --> 00:21:49.181
and if there is a debate,

399
00:21:49.341 --> 00:21:51.963
if it's something that people are very upset about,

400
00:21:52.403 --> 00:21:55.125
then maybe this is a common report.

401
00:21:55.145 --> 00:21:59.347
pricing and reimbursement process could be something to be discussed later.

402
00:21:59.447 --> 00:21:59.968
But right now,

403
00:22:00.008 --> 00:22:00.988
it seems very unlikely.

404
00:22:02.049 --> 00:22:03.390
I would like to conclude with you,

405
00:22:03.870 --> 00:22:04.310
Christopher,

406
00:22:04.390 --> 00:22:08.392
because this is very interesting to have seen discussions.

407
00:22:09.953 --> 00:22:10.554
What do you think?

408
00:22:10.734 --> 00:22:12.655
This is an alert,

409
00:22:13.515 --> 00:22:18.098
something which happens and if Trunks is not here in two or three years,

410
00:22:18.698 --> 00:22:21.240
this kind of question won't appear anymore?

411
00:22:21.760 --> 00:22:23.781
Or this is more a lat...

412
00:22:23.881 --> 00:22:25.122
latent preoccupation

413
00:22:26.222 --> 00:22:27.263
Europe should face.

414
00:22:27.523 --> 00:22:40.951
And I really like your first step to just start talking about this because it's maybe just the beginning of societal discussions and awareness.

415
00:22:41.371 --> 00:22:42.131
What do you think about this?

416
00:22:43.412 --> 00:22:52.037
I think it is clear what I hear from the industry and what I hear from policy experts that the MFN policy

417
00:22:52.545 --> 00:22:58.871
will have decisive changes for the European pharmaceutical market and also for European patient.

418
00:22:59.491 --> 00:23:03.955
What the changes will be is still something that we have to see.

419
00:23:04.316 --> 00:23:05.817
Higher prices seems likely.

420
00:23:06.358 --> 00:23:08.459
Delayed launches is something that we already see.

421
00:23:08.960 --> 00:23:11.462
So the changes and the effects on

422
00:23:12.123 --> 00:23:13.964
European patients are already there.

423
00:23:14.325 --> 00:23:18.909
And these changes might not be just a brief...

424
00:23:20.609 --> 00:23:22.310
wind of incremental changes.

425
00:23:22.350 --> 00:23:28.074
It might be changes that will occur now and then they might develop later.

426
00:23:28.614 --> 00:23:30.775
So the changes might be permanent,

427
00:23:30.875 --> 00:23:33.637
even though the result might develop in the coming time.

428
00:23:34.097 --> 00:23:40.061
I've talked to a lot of people who said that they don't necessarily expect that the next U.S.

429
00:23:40.141 --> 00:23:40.581
government,

430
00:23:40.661 --> 00:23:41.001
be it

431
00:23:41.842 --> 00:23:43.363
Republican or be it Democrat,

432
00:23:43.963 --> 00:23:47.005
will necessarily change this MFN policy.

433
00:23:47.681 --> 00:23:49.162
They have a huge problem over there.

434
00:23:49.202 --> 00:23:50.963
I think a lot of people recognize that.

435
00:23:51.284 --> 00:23:55.346
They have so much higher medicine prices,

436
00:23:55.727 --> 00:23:59.269
sometimes three to four times higher than we have in Europe.

437
00:23:59.689 --> 00:24:00.710
And that's not sustainable.

438
00:24:00.730 --> 00:24:02.331
That's not sustainable for U.S.

439
00:24:02.391 --> 00:24:03.132
patients either.

440
00:24:03.552 --> 00:24:04.012
Not at all.

441
00:24:04.412 --> 00:24:09.116
So there has to happen something for them to bring down the prices in the U.S.

442
00:24:09.356 --> 00:24:14.099
And if Trump's MFN policy succeeds in doing that in one way or another,

443
00:24:14.619 --> 00:24:16.861
I think we will probably see that they've...

444
00:24:17.685 --> 00:24:23.488
The next government will continue or adapt the policy to ensure that U.S.

445
00:24:23.549 --> 00:24:24.929
patients have lower prices.

446
00:24:25.570 --> 00:24:31.093
And this will likely mean that there has to be some changes within the European market.

447
00:24:31.413 --> 00:24:32.133
Higher prices,

448
00:24:32.634 --> 00:24:35.756
different processes of pricing and reimbursement,

449
00:24:36.416 --> 00:24:37.837
more EU coordination,

450
00:24:38.057 --> 00:24:38.837
whatever it could be.

451
00:24:39.498 --> 00:24:45.041
But I think if you're hoping that this will only be a problem during Trump's presidency.

452
00:24:45.513 --> 00:24:47.377
I think you might be a bit too optimistic.

453
00:24:48.319 --> 00:24:48.740
Previously,

454
00:24:48.780 --> 00:24:52.928
we have seen other administrations after the Biden administration took over,

455
00:24:53.008 --> 00:24:54.732
after the first Trump government,

456
00:24:55.413 --> 00:24:57.117
some of the policies that were...

457
00:24:58.062 --> 00:24:59.083
controversial at the time,

458
00:24:59.103 --> 00:24:59.323
maybe,

459
00:25:00.363 --> 00:25:04.506
the Biden administration kept these policies in effect.

460
00:25:04.586 --> 00:25:06.007
So we'll see.

461
00:25:06.487 --> 00:25:13.291
But I don't think you necessarily can hope that this will be a brief trouble with the MFN.

462
00:25:14.452 --> 00:25:14.952
Interesting.

463
00:25:15.092 --> 00:25:18.694
I personally feel concerned because of a European citizen.

464
00:25:19.094 --> 00:25:25.378
I think I would like to see a strong voice and proactive decision and leadership.

465
00:25:26.206 --> 00:25:36.611
resulting to this kind of new order of the world and new powers emerging and maybe protectionism.

466
00:25:37.451 --> 00:25:37.631
But

467
00:25:38.291 --> 00:25:44.814
I think it's important to see also a kind of leadership for Europe.

468
00:25:46.395 --> 00:25:54.038
I just have one interesting note that I'm working on another story about the EU's Biotech Act.

469
00:25:54.750 --> 00:25:55.631
focused on pharma.

470
00:25:56.311 --> 00:25:56.811
In here,

471
00:25:56.952 --> 00:26:07.839
they write that the commission published a report where the staff of the commission calculate or estimate what is the economic impact of the Biotech Act.

472
00:26:08.359 --> 00:26:08.900
And they say,

473
00:26:09.140 --> 00:26:09.340
well,

474
00:26:09.520 --> 00:26:11.742
if some competing countries,

475
00:26:13.123 --> 00:26:19.847
if they substantially change their legislation or the framework for pharma development,

476
00:26:20.408 --> 00:26:23.810
that that could affect how well the Biotech Act will work.

477
00:26:24.602 --> 00:26:25.262
in Europe.

478
00:26:25.682 --> 00:26:39.148
So the potential in increasing the number of clinical trials or in generating more profits that could be invested in European manufacturing or whatever it could be,

479
00:26:39.868 --> 00:26:41.269
the estimates that the commission have,

480
00:26:41.349 --> 00:26:46.151
they might be too optimistic if there is substantial change in the global pharma market,

481
00:26:46.231 --> 00:26:48.652
specifically with competitors such as

482
00:26:49.212 --> 00:26:49.912
US and China.

483
00:26:50.233 --> 00:26:52.553
The The Commission doesn't write this explicitly,

484
00:26:52.974 --> 00:26:53.454
but for me...

485
00:26:53.874 --> 00:26:54.534
As I read it,

486
00:26:54.775 --> 00:26:58.737
it's definitely saying that the potential within the biotech act,

487
00:26:59.658 --> 00:27:01.199
we hope that it's going to be very good.

488
00:27:01.379 --> 00:27:05.982
But if the US MFN policy will have a big effect,

489
00:27:06.463 --> 00:27:10.926
the changes in Europe might be minimal or at least not as much as you hoped for.

490
00:27:11.406 --> 00:27:11.826
So for me,

491
00:27:11.886 --> 00:27:12.927
that is just very interesting.

492
00:27:12.947 --> 00:27:16.730
And that says something about the need for Europe to find solutions,

493
00:27:16.950 --> 00:27:22.494
either in industrial policies or pharmaceutical policies or...

494
00:27:22.834 --> 00:27:34.677
pricing policies that makes it more interesting and attractive for companies to invest and build up research and development and manufacturing within Europe.

495
00:27:35.137 --> 00:27:35.998
How that will happen,

496
00:27:36.438 --> 00:27:37.378
I don't have the answers,

497
00:27:37.478 --> 00:27:39.819
but I hope somebody is thinking about it right now.

498
00:27:40.739 --> 00:27:45.080
If you have to name maybe one decision Europe must take in the next

499
00:27:45.440 --> 00:27:51.622
12 months to avoid being permanently weakened in this landscape,

500
00:27:52.142 --> 00:27:52.322
what

501
00:27:53.143 --> 00:27:55.264
would it be?

502
00:27:55.265 --> 00:27:56.746
That's a very difficult question.

503
00:27:57.866 --> 00:27:58.227
I think,

504
00:27:58.307 --> 00:27:58.547
again,

505
00:27:58.607 --> 00:27:59.868
as I said earlier,

506
00:28:00.368 --> 00:28:03.251
one thing they should do is start talking about it more openly.

507
00:28:03.871 --> 00:28:04.432
I'm a journalist,

508
00:28:04.433 --> 00:28:08.815
so of course I would almost always argue for a public and honest debate.

509
00:28:09.156 --> 00:28:17.142
But I think that's necessary because all the solutions have substantial downsides as well as advantages.

510
00:28:18.423 --> 00:28:21.406
And you really need to have a talk about what What should we do?

511
00:28:22.198 --> 00:28:23.198
And if we do this,

512
00:28:24.519 --> 00:28:27.940
what are the negative and positive potential consequences of this?

513
00:28:28.341 --> 00:28:29.681
And then you need to make a decision.

514
00:28:30.141 --> 00:28:41.126
So I think the first step is to have a public discussion on the impact of the MFN and then the possible solutions and what the downsides and upsides of those could be.

515
00:28:42.126 --> 00:28:42.326
Yes,

516
00:28:42.486 --> 00:28:42.926
really much.

517
00:28:43.287 --> 00:28:43.467
Okay,

518
00:28:43.507 --> 00:28:50.450
we see it's not a simple problem and it's also a completely new problem for the industry.

519
00:28:50.810 --> 00:28:51.350
Bye.

520
00:28:51.670 --> 00:28:54.693
can hear some leaders saying they've never seen that in 20,

521
00:28:54.833 --> 00:28:55.394
30 years.

522
00:28:55.774 --> 00:28:56.274
But that's it.

523
00:28:56.415 --> 00:28:57.996
I think it's the new normality.

524
00:28:58.477 --> 00:29:02.380
But I think what would be interesting in the coming months is the ecosystem.

525
00:29:04.502 --> 00:29:16.273
Is it able to open the question of the prices and to put into different elements to make it more reasonable if prices is not...

526
00:29:17.466 --> 00:29:17.726
For me,

527
00:29:17.886 --> 00:29:18.506
it's interesting.

528
00:29:18.566 --> 00:29:20.187
I recently had an interview with a

529
00:29:20.707 --> 00:29:21.968
Danish patient organization,

530
00:29:23.208 --> 00:29:28.491
and they said we might need to increase the prices short term to be able to ensure that

531
00:29:29.151 --> 00:29:31.472
Danish patients have access to new medicines.

532
00:29:32.032 --> 00:29:37.814
I think when even patient organizations who are usually not the ones to call for higher prices,

533
00:29:38.034 --> 00:29:39.575
which will directly affect their members,

534
00:29:40.455 --> 00:29:43.617
I think that's a clear signal that they are really concerned.

535
00:29:43.797 --> 00:29:46.498
And they're really concerned that they're

536
00:29:47.384 --> 00:29:47.784
Members,

537
00:29:47.924 --> 00:29:55.529
the patients will not get access to new medicines because companies just won't launch it right now in Denmark and maybe other European countries.

538
00:29:55.909 --> 00:29:56.429
So they say,

539
00:29:56.569 --> 00:29:56.749
well,

540
00:29:56.909 --> 00:30:03.013
we'll accept higher prices for a short while to make sure that our patients still have access to the newest medicine.

541
00:30:03.493 --> 00:30:06.355
And I think that speaks volumes.

542
00:30:06.455 --> 00:30:07.075
That says a lot.

543
00:30:07.776 --> 00:30:08.076
Thank you,

544
00:30:08.096 --> 00:30:08.596
Christopher.

545
00:30:09.096 --> 00:30:10.617
We'll continue our investigation.

546
00:30:11.638 --> 00:30:11.778
Yeah,

547
00:30:11.779 --> 00:30:12.098
for sure.

548
00:30:12.438 --> 00:30:12.778
Bye bye.

549
00:30:12.779 --> 00:30:13.319
Thank you very much.

550
00:30:13.979 --> 00:30:15.620
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551
00:30:15.800 --> 00:30:17.424
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00:30:17.644 --> 00:30:19.969
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00:30:20.150 --> 00:30:22.495
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00:30:22.655 --> 00:30:23.798
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