At that moment he had the latest, papers and reptile with aggressive language, but still the question of everything would be diluted between the cruzadas pressures and the industrial lobby.
Hoy esa duda ya doesn’t exist.
Donald Trump has achieved his goal. The government has entered into agreements with major pharmaceutical companies to apply the most-favoured-nation principle (“Most popular nation“, MFN) in the price of medicines.
And it did so not as a political declaration, but through formal industry compromises, accompanied by an operational architecture that allows it to be put into real practice through a specific portal for citizens —TrumpRx.gov—.
From now on, current patients have access to medicines at prices corresponding to the lowest prices in the world.
The message is clear: The EU has decided not to continue paying higher prices than the rest of the world for the same medicines.
Robert F. Kennedy Jr., Secretary of Health of the United States, and Donald Trump, President of the United States.
This change inevitably transcends its borders and transforms the global pharmaceutical market for a simple reason: thanks to price differences, the industry gains more than 50% of its advantages in the EU based on funding for research into innovative products.
In fact, no company can afford to lose structural form margin in this market without compensating for it elsewhere. At the moment we are talking about the purity of the market that finances the European government (Medicare and Medicaid) that covers 25% of the population.
The big problem—and the big problem for everyone—is that the model is driven by prices funded by the private insurance companies that take up most of the North American health care market.
What exactly is the Most Favored Nation principle?
In simple terms, the MFN principle means that countries will not accept that they will pay a higher price for a drug than the lowest price existing in other target countries. This is not a recommendation or a guide: It is a condition accepted by companies for some types of orangery returns.
This does not mean that other countries are obliged to bear the prices by decree, but it points to something much more important: any low price set outside the EEUU has a direct impact on the prevailing price in the US market.
The implications for industry are clear: the value of being a national decision to transform into a globally connected variable.
“The principle of MFN means that the United States will not accept payment for a drug at a higher price than the lowest price existing in other destination countries.”
If the price is “anchored” at the end of other countries, companies have only four platforms to protect their results:
1. Avoid the low official prices that act as an international reference.
2. Return purchases in countries with more adjusted prices.
3. Inflate the official prices and remove the adjustment of confidential and less transparent information.
4. Rent net prices in the market with a political or commercial margin.
All of them directly affect Spain, where the prices of innovative medicines are the lowest. Some studies say that equalizing our prices with those in the EU would increase GDP by 1% to 1.5%.
Although the MFN principle only applies to new medicines, The implications at Largo Plaza for the sustainability of our healthcare system are troubling.
Over the years, our low prices have been a windfall for gas curbs, but with a counterpart: less business attractiveness and reduced access to innovation.
With MFN enabled, this position becomes even more subtle. We do retain regulatory oversight through the Department of Health, but the most likely thing is that while not always paying more in Euros, it has to be paid on time, in access and in perceived tension.
And it also applies to health.
“España needs a clear pharmaceutical strategy that combines inversion, innovation and sustainability”
This scenario also affects the private system. The industry, in order to protect its global pricing architecture, does not differentiate between payers, which will result in first-mover pressure and difficult access to innovation, which will affect models such as mutuals.
Who realizes that this theory should be aimed at the UK. Press releases contain findings that suggest price increases for new drugs in England’s NHS.
It is the previous key: it shows that Europe is not a passive reference and that not all countries negotiate with the same strength.
And where should I go in Spain?
Spain needs a clear pharmaceutical strategy that combines inversion, innovation and sustainability:
1. Strengthen attraction for inversion: Not only in clinical trials, but in production and industrialization. It requires stability and a view of the wide surroundings.
2. Accelerate evaluation and funding: Bureaucracy penalizes the patient. No, if it’s just about enjoying yourself more, until you decide in advance.
3. Improving the common European attitude: Only a single blockade can counter the presence of the US and China.
4. Consider an unpleasant idea: The price cannot be the only one. Value and health impact should come first in a less defensive conversation.
Bottom line: Trump got it, industry embraced it, and the most-favoured-nation principle works. We can’t wait to see them in Europe.
Please note that this will happen in Spain, how and when, and we will be ready.
Because when others decide the rules, the invoice is never paid in cash only. If you pay the same and in the loss opportunities for patients. A moment that our country cannot allow.
*** Juan Abarca Cidón is the president of HM Hospitales.
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