Perspectives

Analysis on evidence architecture and the shifting HTA landscape

July 2026 · Drug pricing · Trade policy

Washington Has Officially Inverted Its Global Drug Pricing Strategy

Recent U.S. policy efforts fixated on International Reference Pricing (MFN) proved structurally unviable. The June 2026 HHS ASPE brief marks the pivot from passive referencing to exported pressure — creating structural conditions to force European net prices up and demanding that EU budgets absorb a more equitable share of global R&D costs.

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June 2026 · Trade policy · Market access

A Collision or a Bilateral Opportunity? Rethinking the U.S.-Germany Pharma Trade Investigation

The U.S. Trade Representative launched a Section 301 investigation into German drug pricing on June 18. Many see this as open conflict — but it may represent a structured bilateral opportunity. Germany’s dynamic rebate system creates a visible target for U.S. negotiators while giving Berlin flexibility to adjust later and present those changes as meaningful concessions.

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June 2026 · Market access · HTA policy

Why placing at the top of the W.A.I.T. index might not be a win

The W.A.I.T. index measures velocity, not value. A country that reimburses everything quickly scores well — but the ultimate metric is total health per unit cost spent. A two-sided test for governments and industry.

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June 2026 · Pricing policy · Trade dynamics

The Atlantic Squeeze: How Big Pharma CEOs Are Being Outplayed by Big Government Trade Tactics

Global pharma companies are pulling billions out of Europe. But viewed through the lens of game theory, the C-suite may be walking straight into a geopolitical trap — mistaking Europe’s defensive negotiation posture for structural market hostility.

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June 2026 · TLV · Global market dynamics

US pricing pressure is now reshaping how Europe launches

TLV interviewed 10 Swedish affiliates on the impact of US MFN pricing policy. The findings: launch delays are materialising, HQ scrutiny has intensified, and TLV is signalling flexibility — pausing planned price cuts and opening the door to confidential, outcomes-based agreements.

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June 2026 · EU JCA · HTA reform

Is the EU’s flagship HTA reform already irrelevant? The strategy behind the first JCA suggests yes.

With the first JCA report on Tovorafenib now public, a close reading of the manufacturer’s evidence strategy reveals something more deliberate than an oversight — and raises a fundamental question about the JCA’s long-term relevance.

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June 2026 · Market access · Industrial policy

Did Europe just pass the point of no return on life sciences innovation? Germany’s €2bn warning.

Boehringer Ingelheim is cutting €900m of planned German investment. Eli Lilly is halving its €2.3bn Alzey manufacturing commitment. The reason cited is not weak science — it is policy uncertainty. That should worry Europe.

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May 2026 · Evidence standards

Evidence standards were built for a world where researchers read before they cited

LLMs now bring science directly to consumers. Editorial and peer review standards were built for researcher-to-researcher communication. They need to reflect a world where the public is more exposed — and the stakes for errors are higher.

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May 2026 · Regulatory landscape

Europe didn’t fall behind by accident

The FDA is moving toward real-time clinical trials. Europe’s share of global clinical investment has collapsed from 22% to 12% over a decade. The bottleneck isn’t approval — it’s access. And Europe designed this outcome.

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April 2026 · HTA policy

The illusion of scientific neutrality in HTA

The HAS open letter functions less like a defence and more like an involuntary confession. HTA is not pure science — it is a purchasing decision informed by scientific inputs.

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April 2026 · Market access

Who actually owns market access decisions after MFN?

With US reimbursement now pegged to OECD reference prices, the US is inside the reference pricing web for the first time. Market access decisions can no longer be made in isolation.

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April 2026 · Innovation policy

Is Europe fixing its innovation problem at the wrong end?

Regulators see acceleration. Market access sees what’s waiting at the other end. Jan Geissler at DIA Europe: “We don’t have an innovation problem. We have an access problem.”

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