"The worst of all outcomes is the current default: the level of Europe's contribution to the world will be decided by America." – Graham Cookson, Economist

Welcome to the 5th episode of Europe's Access Dilemma, the Pharma Minds mini-series on MFN and access to innovation in Europe. Pay more. Wait longer. Or change the model.

Europe wants three things at once: medicines people can afford, fast access to new drugs, and a strong pharma industry. Is that still possible?

My guest is Graham Cookson, Chief Executive of the Office of Health Economics (OHE) in London. He is an econometrician who works on healthcare efficiency, drug pricing and reimbursement. He starts with Germany, the country at the center of MFN.

What you will learn in this episode:

• Germany's trilemma: a big buyer with a budget hole, a big producer of innovation, and a big exporter to the US. That is why it has "a target on its back".
• The MFN paradox: why MFN should push US prices down, and why it is really about US revenues.
• Something has to give: low prices, the latest drugs and more investment are not compatible in the short run.
• The UK deal: paying more for medicines in exchange for tariff relief and investment.
• No single European price: what a "NATO-style" agreement could look like instead.
• The hidden trade-offs: why the worst outcome is letting America decide what Europe pays.
• Health as an investment: why Europe can act as 27 nations, or as one bloc.

Listen to this episode for a European economist's view of pharma's big picture today: which ways out Europe still has, and what each one will cost.

Ressources

Office of Health Economics (OHE) : https://www.ohe.org
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What happens to pharmaceutical innovation when your competitive window shrinks from eight years to just three?

In this episode of Pharma minds, I speak with Marine Baxendell, CFO and co-fonder at xcube.bio, about a fundamental shift in the economics of pharma innovation.

Science is moving faster. Competition is accelerating. And at the same time, MFN pricing, healthcare budget pressures and increasingly complex market access are challenging the traditional model on both sides of the Atlantic.

An innovative treatment could once expect five to eight years before serious competition entered the same space. Today, Marine argues, that window can be closer to two or three years, even while the original molecule remains protected.

So what happens when the time available to capture the value of innovation gets shorter?

We explore:

◾️ Why the next wave of pharma innovation is structurally different

◾️ What MFN reveals about the limits of today’s pricing model

◾️ Why demonstrating patient value earlier is becoming critical

◾️ What is really slowing market access in Europe

◾️ Why being first to market may no longer be enough

◾️ And what a more sustainable model for pharma, payers and patients could look like

Marine’s perspective reframes MFN not simply as a threat, but as a signal that the rules of pharmaceutical innovation are changing.

This is episode #4 of Europe’s Access Dilemma: five perspectives on how Europe can make innovation affordable.

To find Marine Baxendell:

LinkedIn: https://www.linkedin.com/in/marine-baxendell/

Resources mentioned in the episode:

📌 xcube.bio : https://xcube.bio/

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MFN isn't just a pricing debate. It is already changing how pharma companies think about where, when and how they launch new medicines.

In this episode of Pharma minds, I speak with Laure Nas de Tourris, Partner at Clarivate, about what she is seeing on the ground as pharma and biotech leaders start adapting their commercial strategies to the new Most Favored Nation (MFN) environment.

And one thing is clear:uncertainty is here to stay.

From early-stage assets to upcoming launches and portfolio decisions, MFN is forcing companies to rethink the traditional launch playbook. US and European pricing have always been interconnected, but those links now need to be considered much more intentionally, and much earlier, from Phase I or II of development. Launch sequencing is becoming more complex, requiring teams to anticipate the impact across markets from the very beginning.

We explore:

◾️ Why MFN has become a top-of-mind issue for pharma leaders

◾️ How MFN is already changing global launch sequencing

◾️ Why even rare disease and early-stage assets may need to prepare

◾️ How scenario planning can help teams navigate regulatory and pricing uncertainty

◾️ Why commercial, market access, medical and other functions need to work together much earlier

◾️ How pharma companies can build more flexible go-to-market models

◾️ When it may make sense to deprioritize an indication, market or investment

◾️ What delayed launches could ultimately mean for patient access to innovation

◾️ And why “wait and see” may be one of the riskiest strategies of all

The companies best prepared for what comes next will not necessarily be those that correctly predict exactly how MFN will unfold. They will be those that build different scenarios, preserve optionality, connect decisions across their portfolio and prepare their teams early.

Because under MFN, the old launch playbook may not be enough.

This is episode #3 of Europe’s Access Dilemma: five perspectives on how Europe can make innovation affordable.

To find Laure Nas de Tourris:

LinkedIn: https://www.linkedin.com/in/laurenasdetourris/

MFN as a Catalyst for Strategic Reinvention https://clarivate.com/life-sciences-healthcare/wp-content/uploads/sites/4/dlm_uploads/2026/09/MFN-as-Catalyst-for-Reinvention-Clarivate.pdf
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