According to a study published in the scientific journal The Lancet, Donald Trump’s proposed drug-pricing strategy for the United States could trigger price hikes across Europe and delay the arrival of new pharmaceutical treatments to European markets. The administration’s approach relies on a "most-favoured-nation" (MFN) model, which would link prices paid by U.S. federal healthcare programs to the lower values practiced in other developed nations. Researchers warn that using European price points as an American benchmark threatens to disrupt global pharmaceutical market incentives.
How the ‘Most-Favoured-Nation’ Price Model Alters Global Pharma Incentives
The core mechanism of the U.S. proposal ties American drug costs directly to foreign reference pricing. According to investigators, pharmaceutical companies face stark financial repercussions if Washington forces down domestic prices. An analysis of 195 patented drugs—representing 87.9 billion dollars in annual U.S. spending—revealed that financial losses from a U.S. price reduction would eclipse total annual sales in reference countries.
To protect higher American revenues, drugmakers have a strong economic incentive to prevent European prices from dropping too low. As researchers point out, manufacturers may actively seek higher price tags in European markets or simply delay launching new therapies abroad. By withholding a drug from a lower-priced European nation, a company prevents that figure from serving as an unfavorable baseline for U.S. price negotiations. Kerstin Vokinger, a researcher at ETH Zurich and the University of Zurich who authored the study, stated that U.S. policies can directly impact medical access worldwide.
Vulnerabilities in Portugal’s International Reference Pricing System
Portugal’s domestic pharmaceutical market sits squarely in the crosshairs of these potential shifts, due to a decades-old international reference pricing framework. According to Infarmed, the National Authority of Medicines and Health Products, Portugal has used external price referencing since 1990 for the outpatient market and since 2013 for the hospital sector. For 2026, Portugal’s designated reference nations comprise Spain, France, Italy, and Belgium.
Because Portugal does not set medication costs in isolation, regional European price adjustments ripple directly through the national system during both initial market entry and annual reviews. Furthermore, Infarmed notes a mutual dependency: Portuguese drug prices serve as an official benchmark for numerous other European nations, including Germany, Spain, Italy, Belgium, Austria, and Greece. Consequently, any American-driven pressure altering European baseline costs directly threatens Portugal’s delicate balance between public expenditure sustainability and patient accessibility.
Did You Know? Data cited by Reuters shows that in the ten months following a major executive order by Donald Trump targeting pharmaceutical costs, new drug launches across European Union markets dropped by roughly 35% compared to the preceding ten months, highlighting the immediate volatility in cross-border treatment availability.
Patient Access Risks and Declining European Drug Launches
The broader European patient community is already feeling the pinch of shifting commercial strategies. The European Patients Forum warned in written statements to Euronews Health that the risk of delayed treatment access is concrete. For individuals managing progressive or severe illnesses, additional waiting times directly endanger health outcomes and quality of life.
Alexander Natz, director of the European biotechnology association Eucope, has previously highlighted the complex trade-offs inherent in these pricing pressures. While policymakers in Washington aim to relieve American consumers from paying significantly more than citizens in other developed nations, European health systems are left managing the fallout. As pharmaceutical companies weigh where to debut costly new therapies, the central question for European regulators remains stark: who will ultimately foot the bill for reduced American prices?
Frequently Asked Questions
What is the ‘most-favoured-nation’ drug pricing model?
The MFN model is a proposed U.S. policy strategy designed to cap the prices paid by American public health programs by aligning them with the lowest prices found in other developed nations.
Why are European researchers concerned about U.S. drug pricing?
According to a study in The Lancet, linking U.S. prices to European benchmarks gives pharmaceutical companies a financial incentive to raise prices in Europe or delay launching new drugs there to avoid lowering their baseline American profits.
How does Portugal determine prescription drug prices?
According to Infarmed, Portugal utilizes an international reference pricing system—comparing costs against countries like Spain, France, Italy, and Belgium—during initial drug approvals and annual price reviews.
Could patients in Portugal face treatment delays?
Researchers and patient advocacy groups warn that if manufacturers restructure their global launch schedules to protect U.S. revenues, European patients could experience longer waiting times for new therapies.
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