European study shows inequality in access to new medicines

An analysis by pharma trade body EFPIA has found "widening equality" in the access to new medicines across 36 European countries that could be compounded by the introduction of the Most Favoured Nation (MFN) pricing policy in the US.

The new WAIT Indicator (PDF) report, which has been running for more than 20 years and is compiled with the help of IQVIA, has found that almost half (49%) of a group of 168 medicines approved between 2021 and 2024 were not available to patients in Europe last year, continuing an annual upward trend that has been in place for many years.

Moreover, there was an 88% access disparity between the highest and lowest European countries, with a median time to availability of 56 days in Germany, ranging to 1,201 days in Romania. Overall, the average time to availability was 532 days.

"Europe has had medicines access problems for 25 years, and global pricing reforms are set to exacerbate these issues," said EFPIA director general Nathalie Moll, alluding to the MFN policy introduced by President Trump that sets the price for a medicine in the US at the same level as is offered in 'comparable' countries.

There have already been cases in which pharma companies have said they may hold off on launching new medicines in some European markets, unless they can secure more favourable pricing, to avoid skewing the MFN price that will apply in the US. There have also been warnings of an exodus from Europe in terms of capital investments and carrying out clinical trials.

Echoing that sentiment, Moll said: "It is unrealistic to expect greater investment into Europe and faster access to new treatments for Europeans if member states also demand the lowest possible prices and highest government clawback rates. We need to make a choice."

Other findings from the report include that the share of medicines fully available on public reimbursement lists has declined substantially, to 28% in 2025 from 42% in 2019, while the proportion of drugs that are available with restricted usage has risen from 6% to 17% over the same period.

A separate analysis by EFPIA looking at new drug approvals in the last 18 months suggests a decline in the number of FDA-approved medicines that are subsequently cleared by the EMA, and – if that trend persists – China could soon overtake the EU on this metric.

The trade organisation is calling for immediate access to newly approved drugs, while reimbursement deliberations take place, and an increase in spending on new medicines across the EU from its current levels of 1% of GDP, which is less than then 2% spent in the US and 1.8% in China.