EU must defend its medicines pricing model against US pressure, Belgian minister argues

Europe should resist American pressure to increase medicine prices while strengthening its own pharmaceutical innovation ecosystem, according to a new Egmont Institute paper by Belgian Deputy Prime Minister and Health Minister Frank Vandenbroucke and his deputy head of cabinet, Gloria Ghéquière.

The paper, Does Europe Pay Too Little for Its Medicines?, challenges Washington’s claim that Europeans benefit unfairly from American pharmaceutical innovation by paying less for medicines.

The authors argue that US President Donald Trump’s “most-favored-nation” pricing policy, which links American medicine prices to those in other wealthy countries, threatens European healthcare systems without guaranteeing substantial savings for American patients.

“American prices reflect the organisation of the American market,” they write, pointing to fragmented purchasing arrangements and the absence of collective price negotiations.

The paper identifies three priorities for European policymakers: defending national healthcare systems against external pressure, closing Europe's pharmaceutical investment gap, and developing EU-wide incentives for research and manufacturing.

A co-ordinated European response

Vandenbroucke and Ghéquière urge the European Commission to consider activating the EU’s Anti-Coercion Instrument in response to American trade pressure on European pharmaceutical pricing.

Although medicine reimbursement remains a national responsibility, they argue that threats targeting individual member states demand a collective European response.

“The responsibility to defend the integrity of the European market thus falls to the European Commission,” they state.

Opening an anti-coercion investigation would signal that Brussels will defend member states’ healthcare choices and discourage governments from negotiating separate arrangements with Washington.

The authors also recommend suspending EU tariff concessions under the transatlantic trade agreement if Washington introduces additional pharmaceutical tariffs.

Addressing Europe's innovation gap

Rather than raising medicine prices across the board, the paper calls for investment where Europe faces genuine competitive weaknesses.

It highlights a striking financing disparity: EU health-biotechnology companies attracted approximately €25 billion in venture funding between 2015 and mid-2025, compared with €219 billion in the United States.

The proposed European Biotech Act offers a potential response through investment instruments, faster clinical-trial authorisations and support for promising companies.

However, the authors caution that existing financial proposals may be insufficient to prevent European discoveries from being commercialized elsewhere.

A European framework for incentives

The paper also advocates targeted incentives rewarding pharmaceutical companies for conducting research, clinical trials and manufacturing within the EU.

While France and Germany are developing national approaches, the authors warn that competing national schemes risk fragmenting the single market and disadvantaging smaller countries.

“The answer should therefore be a European framework rather than a series of national preferences,” they argue.

The paper calls for Europe to combine its collective bargaining power, strengthen innovation financing and coordinate industrial policy to protect affordable access to medicines while promoting pharmaceutical investment.