Syneos Health Commercial Solutions

Leandro has been working in consulting for more than eight years. He has helped 50+ clients optimize and implement global pricing and market access strategies, in various therapeutic areas and across multiple product classes.

Audrey Lee has more than four years of specialized experience in pricing and market access consulting, with a strong track record of delivering more than 20 global projects across access channel mapping, value assessment, payer insights and pricing strategy.

Redefining Global Pricing Strategy

Growing momentum behind the United States Most Favored Nation (MFN) drug pricing policy is forcing pharmaceutical manufacturers to reassess how global pricing decisions interact across markets.

Several US policy proposals would benchmark domestic prices to those observed in a defined basket of international reference countries, most of which are European. Because European prices are typically significantly lower than US prices, this approach could materially erode US revenue for in-line assets marketed in both regions. Recent MFN models under discussion include GLOBE (Medicare Part B), GUARD (Medicare Part D), and GENEROUS (a voluntary Medicaid model).

While differing in implementation, all share a common design principle: US prices would be anchored to the lowest or near-lowest observed international prices, potentially incorporating both list and net price data. This represents a paradigm shift. European pricing, historically downstream in global strategy, may directly influence the future US price corridor.

Unlocking European Repricing Opportunities

For manufacturers with established European portfolios, this changing policy landscape elevates the importance of proactive price management for in-line assets. Although price increases in Europe have historically been infrequent, highly scrutinized and context dependent, MFN pressure is likely to normalize repricing discussions, provided actions are compliant, evidencebased and strategically selective.

Across Europe, existing regulatory mechanisms allow for repricing under specific conditions. These pathways generally fall into four categories. Cost-driven price revisions may be permitted when rising production or supply costs materially affect the economic viability of a product. Evidence-driven reassessments can be pursued when new clinical data, real-world evidence or comparative analyses strengthen a product’s value proposition relative to its original health technology assessment.

“As MFN evolves from policy concept toward operational reality, integrating European pricing strategy into global portfolio management will become a core strategic capability.”

Market sustainability and supply protection represent a third pathway. In cases where manufacturers can demonstrate that current price levels threaten continued supply or risk market withdrawal, authorities may accept price increases to preserve access. Finally, product reconfiguration strategies, such as introducing new formulations, strengths or SKUs, can effectively reset price anchors without reopening historical agreements, offering an alternative route to improving price positioning.

Balancing Feasibility with MFN Risk

Not all markets or products warrant intervention. Under an MFN-influenced environment, repricing decisions should be guided by two dimensions, the feasibility of price adjustment and MFN exposure.

Feasibility reflects the availability of formal mechanisms, evidence requirements, administrative complexity and historical payer precedent in each country. MFN exposure captures the degree to which a given product and market influences global price benchmarks and, ultimately, potential US revenue at risk.

Choosing the Right Pricing Response

Overlaying these dimensions enables a structured prioritization approach. High-exposure, high-feasibility situations may justify active intervention, supported by tailored evidence generation and early payer engagement.

High-exposure but low-feasibility cases call for structural risk management, such as contract redesign, scenario planning and monitoring for future reassessment opportunities, rather than immediate price action. Low-exposure scenarios generally warrant caution, given the potential for unintended spillover through international reference pricing systems.

Building a Global Pricing Strategy for MFN

MFN policy durability remains uncertain, with legal and political challenges potentially reshaping timelines or scope. The role of confidential net prices is also unclear, particularly in European markets where rebates and discounts are legally protected.

In addition, any price increase may trigger payer scrutiny, reassessment of value or access restrictions if not carefully justified. Ultimately, mitigating MFN risk is not about broad price hikes, but about disciplined global price governance.

Manufacturers that map their global price corridors, identify assets contributing to international price floors, and selectively deploy compliant European repricing levers will be better positioned to protect US revenue while preserving long-term access. As MFN evolves from policy concept toward operational reality, integrating European pricing strategy into global portfolio management will become a core strategic capability