A decision made in Washington could influence when a new cancer medicine reaches patients in Europe. The evidence is not yet conclusive, but the concern is credible. By linking some US medicine prices to those paid abroad, the United States may give manufacturers a reason to seek higher prices in Europe or delay launches in countries with lower prices.

What Most Favoured Nation Pricing Means

In May 2025, the US administration directed federal agencies to pursue Most Favoured Nation, or MFN, pricing. The aim is to bring the prices paid by US public programmes closer to those in other economically comparable countries.

The US Centers for Medicare and Medicaid Services later proposed two mandatory Medicare models. GLOBE would cover selected medicines paid under Medicare Part B, which are usually administered in hospitals or clinics. GUARD would cover selected medicines paid under Medicare Part D, which are usually dispensed by pharmacies. When a medicine’s US price exceeds the international benchmark, the manufacturer may owe Medicare an additional rebate.¹

For cancer care, GLOBE is particularly relevant because many oncology medicines are administered in clinical settings. Any change in launch timing or location could therefore affect when people with digestive cancers gain access to new treatment options.

Why Europe Could Be Affected

The proposed models compare US prices with prices in 19 countries, including several EU Member States. If a lower European price reduces what a manufacturer can receive from Medicare in the much larger US market, the company may be incentivised to seek a higher price, postpone a launch where prices are lower, or decide not to launch in that market.

These are plausible responses, not proven consequences. Launch decisions already depend on marketing authorisation, national pricing and reimbursement procedures, evidence requirements, expected demand and negotiations with health authorities. MFN adds another commercial consideration to an already complex process.

What the Evidence Shows So Far

In June 2026, EU health ministers asked the European Commission to assess whether US pharmaceutical pricing policies were contributing to delayed launches, higher prices or reduced access to medicines in Europe.²

The Commission prepared an analysis for Member States, but has not published it. According to media reports, the analysis says it is too early to determine whether observed delays or price pressure are caused by US policy or by uncertainty surrounding its implementation.³

IQVIA reached a similar conclusion in July. It found that the recent decline in launches in major European markets appeared to have begun before the MFN announcement in May 2025. Usual variation from year to year and the typical delay between US and European launches also make the current trend difficult to interpret.⁴

A cohort study published in The Lancet in September 2026 helps explain why the concern persists. Researchers analysed 195 branded medicines representing US$87.9 billion in annual Medicare spending. For about three quarters of medicines with available sales data, the projected US savings exceeded the medicine’s annual sales in the country used to set the benchmark. That creates a potential incentive to change prices or launch strategies.⁵

The study models financial incentives. It does not show that European launches have already been delayed.

What This Means for Patients

For patients, uncertainty is the central finding. There is currently no reliable evidence that MFN is already delaying cancer medicines in Europe. The policy could nevertheless intensify pressure on access systems that already produce wide differences between countries. EFPIA’s 2026 WAIT Indicator found that the availability of, and waiting times for, new medicines continue to vary substantially across Europe.⁶

For someone with a serious or progressive cancer, additional waiting can affect treatment choices, health and quality of life. The issue is therefore not simply whether a medicine is cheaper in one country or more expensive in another. It is whether global pricing decisions change when and where patients can receive an effective treatment.

What DiCE Will Monitor

DiCE will follow whether launch timelines change across Member States, whether national authorities face pressure to accept higher prices and whether any shift reduces access to cancer medicines. We will also look for evidence on which countries and patient groups are most affected, since any impact is unlikely to be evenly distributed.

A policy that lowers costs in the United States should not create avoidable delays or deepen access inequalities in Europe. Timely and equitable access to effective cancer care must remain the test against which these policies are judged.

References

1. US Centers for Medicare and Medicaid Services, GLOBE Model and GUARD Model, 2025.
2. Euronews, EU health chief to probe effects of Trump’s drug pricing push, 16 June 2026.
3. Euronews, US push to cut drug prices could mean longer waits for European patients, 14 September 2026.
4. IQVIA, Tracking MFN’s impact on innovative medicine launches: separating the signal from the noise, 17 July 2026.
5. Hwang TJ and colleagues, Most favoured nation pricing for prescription drugs in US Medicare: a cohort study, The Lancet, 13 September 2026.
6. European Federation of Pharmaceutical Industries and Associations, Patients in Europe waiting longer for new medicines as inequality grows between Member States, 19 May 2026.