The UK has historically been a global leader in life sciences innovation, but recent statistics paint a worrying picture for medicines access. The right policy can start to reverse this. We are living in a time where the intersection between breakthrough science, technology and data insights has the potential to transform treatment options for some of the toughest health conditions faced by patients in the UK. The UK has long played a central role in driving innovation when it comes to healthcare, and at Johnson & Johnson (J&J) we were pleased to see some positive signs from the Government at the end of 2025, illustrating an intent to reverse a decade of decline of investment in how the UK values innovative treatments. It was a positive first step, but now the real work begins to enable us to deliver the best possible outcomes for UK patients. To achieve this, our focus must be on ensuring our health system is set up to match the pace and gain the benefits of innovation that science provides. We need a supportive medicines environment that fully fosters growth, because even the most pioneering drugs and therapies are only valuable if they can be accessed by patients when they need them most. > even the most pioneering drugs and therapies are only valuable if they can be > accessed by patients when they need them most. At J&J, we are proud to have been part of the UK’s health innovation story for more than a century. We believe that turning ambition into delivery requires a clearer focus on the foundations that enable innovation to reach patients. We have had a substantial and long-term economic presence, with our expertise serving as the grounds for successful partnerships with patients, healthcare providers, clinical researchers and the NHS. Recent national developments are a step in the right direction The UK Government’s recent announcements on the life sciences industry are an important move to help address concerns around medicines access, innovation and the UK’s international standing. This includes a welcome planned increase to the baseline cost-effectiveness threshold (the first change to be made since its introduction in the early 2000s). While it is crucial to get this implemented properly, this seems like a step in the right direction — providing a starting point towards meaningful policy reform, industry partnership and progress for patients. The true impact of stifling medicine innovation in the UK compared with our peers These positive developments come at a critical time, but they do not fix everything. Over the past decade, spending on branded medicines has fallen in real terms, even as the NHS budget has grown by a third.[i] Years of cost-containment have left the UK health system ill-prepared for the health challenges of today, with short-term savings creating long-term consequences. Right now, access to innovative medicines in the UK lags behind almost every major European country[ii]; the UK ranks 16th and 18th among 19 comparable countries for preventable and treatable causes of mortality.[iii]These are conditions for which effective medicines already exist. Even when new medicines are approved, access is often restricted. One year after launch, usage of innovative treatments in England is just over half the average of comparator countries such as France, Germany and Spain.[iv] The effect is that people living with cancer, autoimmune conditions and rare diseases wait longer to access therapies that are already transforming lives elsewhere in Europe. And even at its new level, the UK’s Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG) clawback rate remains higher than in comparable countries.[v] J&J is committed to working together to develop a new pricing and access framework that is stable, predictable and internationally competitive — enabling the UK to regain its position as a leading destination for life sciences. Seeing the value of health and medicines investment as a catalyst for prosperity and growth Timely access to the right treatment achieves two things; it keeps people healthy and prevents disease worsening so they can participate in society and a thriving economy. New research from the WifOR Institute, funded by J&J, shows that countries that allocate more resources to health — especially when combined with a skilled workforce and strong infrastructure — consistently achieve better outcomes.[vi] > Timely access to the right treatment achieves two things; it keeps people > healthy and prevents disease worsening so they can participate in society and > a thriving economy. The UK Government’s recent recognition of the need for long-term change, setting out plans to increase investment in new medicines from 0.3 percent of GDP to 0.6 percent over the next 10 years is positive. It signals a move towards seeing health as one of our smartest long-term investments, underpinning the UK’s international competitiveness by beginning to bring us nearer to the levels in other major European countries. This mindset shift is critical to getting medicines to patients, and the life sciences ecosystem, including the pharmaceutical sector as a cornerstone, plays a pivotal role. It operates as a virtuous cycle — driven by the generation, production, investment in, access to and uptake of innovation. Exciting scientific developments and evolving treatment pathways mean that we have an opportunity to review the structures around medicines reimbursement to ensure they remain sustainable, competitive and responsive. At J&J, we have the knowledge and heritage to work hand-in-hand with the Government and all partners to achieve this. Together, we can realise the potential of medicine innovation in the UK Patients have the right to expect that science and innovation will reach them when they need it. Innovative treatments can be transformative for patients, meaning an improved quality of life or more precious time with loved ones. We fully support the Government’s ambitions for life sciences and the health of the nation. Now is the moment to deliver meaningful change — the NHS, Government and all system partners, including J&J, must look at what valuing innovation actually means when it comes to modernising the frameworks and mechanisms that support access and uptake. Practical ways to do this include: * Establishing a new pricing and access framework that is stable, predictable and internationally competitive. * Evolving medicines appraisal methods and processes, to deliver on the commitments of the UK-US Economic Prosperity Deal. * Adapting thresholds and value frameworks to ensure they are fit for the future — in the context of wider system pressures, including inflation, and the evolution of medical innovation requiring new approaches to assessment and access. > the NHS, Government and all system partners, including J&J, must look at what > valuing innovation actually means when it comes to modernising the frameworks > and mechanisms that support access and uptake. By truly recognising the value of health as an investment, rather than as a cost, we can return the UK to a more competitive position. The direction of travel is positive. At J&J, we stand ready to work in partnership to help ensure the UK is once again the best place in the world to research, develop and access medicines. Follow Johnson & Johnson Innovative Medicine UK on LinkedIn for updates on our business, our people and our community. CP-562703 | January 2026 -------------------------------------------------------------------------------- [i] House of Commons Library (2026). ‘NHS Funding and Expenditure’ Research Briefing. Available at: https://commonslibrary.parliament.uk/research-briefings/sn00724/ (Accessed January 2026). [ii] IQVIA & EFPIA (2025). EFPIA Patients W.A.I.T Indicator 2024 Survey. Available at: https://efpia.eu/media/oeganukm/efpia-patients-wait-indicator-2024-final-110425.pdf. (Accessed January 2026) [iii] The Kings Fund (2022). ‘How does the NHS compare to the health care systems of other countries?’ Available at: https://www.kingsfund.org.uk/insight-and-analysis/reports/nhs-compare-health-care-systems-other-countries (Accessed January 2026) [iv] Office for Life Sciences (2024). Life sciences competitiveness indicators 2024: summary. Available at: https://www.gov.uk/government/publications/life-sciences-sector-data-2024/life-sciences-competitiveness-indicators-2024-summary (Accessed January 2026). [v] ABPI. VPAG payment rate for newer medicines will be 14.5% in 2026. December 2025. Available at: https://www.abpi.org.uk/media/news/2025/december/vpag-payment-rate-for-newer-medicines-will-be-145-in-2026/. (Accessed January 2026). [vi] WifOR Institute (2025). Healthy Returns: A Catalyst for Economic Growth and Resilience. Available at: https://www.wifor.com/en/download/healthy-returns-a-catalyst-for-economic-growth-and-resilience/?wpdmdl=360794&refresh=6942abe7a7f511765977063. (Accessed January 2026).

LONDON — It’s a far cry from the ice age of U.K.-China relations that characterized Rishi Sunak’s leadership — and it’s not exactly David Cameron’s “golden era,” either.  As U.K. Prime Minister Keir Starmer embarks on his Chinese charm offensive against a turbulent economic backdrop, he has opted for a softly-softly approach in a bid to warm up one of Britain’s most important trading partners — a marked departure from his Tory predecessors. With the specter of U.S. President Donald Trump looming over the visit — not to mention national security concerns back home — Starmer’s cautious optimism is hardly surprising.  Despite reservations from China skeptics, Starmer’s trip — the first such visit by a British prime minister since 2018 — was peppered with warm words and a smattering of deals, some more consequential than others. Britain’s haul from the trip may be modest, but it’s just the beginning, Business and Trade Secretary Peter Kyle — who joined Starmer on the trip — told a traveling pack of reporters in Beijing. “This visit is a springboard,” the minister said. “This is not the last moment, it is a springboard into a future with far more action to come.” STEP-BY-STEP On the ground in Beijing, British officials gave the impression that the prime minister was focused on getting as many uncontroversial wins over the line as possible, in a bid to thaw relations with China. That’s not to say Starmer and his team don’t have a few tangible wins to write home about. Headline announcements include a commitment from China to allow visa-free travel for British tourists and business travelers, enabling visits of up to 30 days without the need for documents.   The provisions are similar to those extended to 50 other countries including France, Germany, Italy, Australia and Japan. The timings of the visa change have not yet been set out publicly, but one official — who, like others cited in this piece, was granted anonymity to speak freely — said they were aiming to get it nailed down in coming months. “From a business standpoint, it will reduce a lot of friction,” said a British business representative, adding it will make it easier for U.K. firms to explore opportunities and form partnerships. “China is very complicated. You have to be on the ground to really assess opportunities,” they said, adding visa-free travel “will make things a lot easier.” The commitment to visa-free travel forms part of a wider services package aimed at driving  collaboration for businesses in healthcare, financial and professional services, legal services, education and skills — areas where British firms often face regulatory or administrative hurdles.  The countries have also agreed to conduct a “feasibility study” to explore whether to enter negotiations towards a bilateral services agreement. If it goes ahead, this would establish clear and legally binding rules for U.K. firms doing business in China. Once again, the timeframe is vague. David Taylor, head of policy at the Asia House think tank in London, said “Xi’s language has been warmer and more expansive, signaling interest in stabilizing the relationship, but the substance on offer so far remains tightly defined.” “Beyond the immediate announcements, progress — particularly on services and professional access — will be harder and slower if it happens at all,” he added. WHISKY TARIFF RELIEF Another victory talked up by the British government is a plan for China to slash Scotch whisky tariffs by half, from 10 percent to 5 percent.  However, some may question the scale of the commitment, which effectively restores the rate that was in place one year ago, ahead of a doubling of the rate for whisky and brandy in February 2025. The two sides have not yet set out a timeframe for the reduction of tariffs.  Speaking to POLITICO ahead of Starmer’s trip, a senior business representative said the whisky and brandy issue had become “China leverage” in talks leading up to the visit. However, they argued that even a removal of the tariff was “not going to solve the main issue for British whisky companies in China and everywhere, which is that people aren’t buying and drinking whisky.” CHINA INVESTMENT WIN Meanwhile, China can boast a significant win in the form of a $15 billion investment in medicines manufacturing and research and development from British pharmaceutical giant AstraZeneca.  ING Bank’s global healthcare lead Stephen Farelly said that increasing investment into China “makes good business sense,” given the country is “now becoming a force in biopharma.” However, it “does shine a light on the isolation of Europe and the U.K. more generally, where there is a structural decline in investment and R&D.” AstraZeneca recently paused a £200 million investment at a Cambridge research site in September last year, which was due to create 1,000 jobs.  Britain recently increased the amount the NHS pays for branded, pharmaceutical drugs, following heavy industry lobbying and following trade negotiations with the Trump administration — all in the hopes of attracting new investment into the struggling sector.  Shadow Trade Secretary Andrew Griffith was blunt in his assessment. “AstraZeneca’s a great British company but under this government it’s investing everywhere in the world other than its U.K. home. When we are losing investment to communist China, alarm bells should be ringing in No 10 Downing Street.” Conspicuously absent from Starmer’s haul was any mention of net zero infrastructure imports, like solar panels, a reflection of rising concerns about China’s grip on Britain’s critical infrastructure. XI RETURNS So what next? As Starmer prepares to fly back home, attention has already turned to his next encounter with the Chinese leader.  On Thursday, Britain opened the door to an inward visit by Xi Jinping, with Downing Street repeatedly declining to rule out the prospect of welcoming him in future. Asked about the prospect of an inward visit — which would be the first for 11 years — Starmer’s official spokesperson told reporters: “I think the prime minister has been clear that a reset relationship with China, that it’s no longer in an ice age, is beneficial to British people and British business.” As Starmer’s trip draws to a close, one thing is certain: there is more to come. “This isn’t a question of a one-and-done summit with China,” Starmer’s spokesperson added. “It is a resetting of a relationship that has been on ice for eight years.”

LONDON — Keir Starmer is off to China to try to lock in some economic wins he can shout about back home. But some of the trickiest trade issues are already being placed firmly in the “too difficult” box. The U.K.’s trade ministry quietly dispatched several delegations to Beijing over the fall to hash out deals with the Chinese commerce ministry and lay the groundwork for the British prime minister’s visit, which gets going in earnest Wednesday. But the visit comes as Britain faces growing pressure from its Western allies to combat Chinese industrial overproduction — and just weeks after Starmer handed his trade chief new powers to move faster in imposing tariffs on cheap, subsidized imports from countries like China. For now, then, the aim is to secure progress in areas that are seen as less sensitive. Starmer’s delegation of CEOs and chairs will split their time between Beijing and Shanghai, with executives representing City giants and high-profile British brands including HSBC, Standard Chartered, Schroders, and the London Stock Exchange Group, alongside AstraZeneca, Jaguar Land Rover, Octopus Energy, and Brompton filling out the cast list. Starmer will be flanked on his visit by Trade Secretary Peter Kyle and City Minister Lucy Rigby. Despite the weighty delegation, ministers insist the approach is deliberately narrow. “We have a very clear-eyed approach when it comes to China,” Security Minister Dan Jarvis said Monday. “Where it is in our national interest to cooperate and work closely with [China], then we will do so. But when it’s our national security interest to safeguard against the threats that [they] pose, we will absolutely do that.” Starmer’s wishlist will be carefully calibrated not to rock the boat. Drumming up Chinese cash for heavy energy infrastructure, including sensitive wind turbine technology, is off the table. Instead, the U.K. has been pushing for lower whisky tariffs, improved market access for services firms, recognition of professional qualifications, banking and insurance licences for British companies operating in China, easier cross-border investment, and visa-free travel for short stays. With China fiercely protective of its domestic market, some of those asks will be easier said than done. Here’s POLITICO’s pro guide to where it could get bumpy. CHAMPIONING THE CITY OF LONDON Britain’s share of China’s services market was a modest 2.7 percent in 2024 — and U.K. firms are itching for more work in the country. British officials have been pushing for recognition of professional qualifications for accountants, designers and architects — which would allow professionals to practice in China without re-licensing locally — and visa-free travel for short stays. Vocational accreditation is a “long-standing issue” in the bilateral relationship, with “little movement” so far on persuading Beijing to recognize U.K. professional credentials as equivalent to its own, according to a senior industry representative familiar with the talks, who, like others in this report, was granted anonymity to speak freely. But while the U.K.’s allies in the European Union and the U.S. have imposed tariffs on Chinese EVs, the U.K. has resisted pressure to do so. | Jessica Lee/EPA Britain is one of the few developed countries still missing from China’s visa-free list, which now includes France, Germany, Italy, Spain, the Netherlands, Switzerland, Australia, New Zealand, Japan, Saudi Arabia, Russia and Sweden.  Starmer is hoping to mirror a deal struck by Canadian PM Mark Carney, whose own China visit unlocked visa-free travel for Canadians.  The hope is that easier business travel will reduce friction and make it easier for people to travel and explore opportunities on the ground — it would allow visa-free travel for British citizens, giving them the ability to travel for tourism, attend business conferences, visit friends and family, and participate in short exchange activities.  SMOOTHING FINANCIAL FLOWS The Financial Conduct Authority’s Chair Ashley Alder is also flying out to Beijing, hoping to secure closer alignment between the two countries’ capital markets. He’ll represent Britain’s financial watchdog at the inaugural U.K-China Financial Working Group in Beijing — and bang the drum for better market connectivity between the U.K. and China. Expect emphasis on the cross-border investments mechanism known as the Shanghai-London and Shenzhen-London Stock Connect, plus data sovereignty issues associated with Chinese companies jointly listing on the London Stock Exchange, two figures familiar with the planning said. The Stock Connect opened up both markets to investors in 2019 which, according to FCA Chair Ashley Alder, led to listings worth almost $6 billion. “Technical obstacles have so far prevented us from realizing Stock Connect’s full potential,” Alder said in a speech last year. Alder pointed to a memorandum of understanding being drawn up between the FCA and China’s National Financial Regulatory Administration, which he said is “critical” to allow information to be shared quickly and for firms to be supervised across borders. But that raises its own concerns about Chinese use of data. “The goods wins are easier,” said a senior British business representative briefed on the talks. “Some of the service ones are more difficult.” TAPPING INTO CHINA’S BIOTECH BOOM Pharma executives, including AstraZeneca’s CEO Pascal Soriot, are among those heading to China, as Britain tries to burnish its credentials as a global life sciences hub — and attract foreign direct investment. China, once known mainly for generics — cheaper versions of branded medicine that deliver the same treatment — has rapidly emerged as a pharma powerhouse. According to ING Bank’s global healthcare lead, Stephen Farrelly, the country has “effectively replaced Europe” as a center of innovation. ING data shows China’s share of global innovative drug approvals jumped from just 4 percent in 2014 to 27 percent in 2024. Pharma executives, including AstraZeneca’s CEO Pascal Soriot, are among those heading to China, as Britain tries to burnish its credentials as a global life sciences hub — and attract foreign direct investment. | John G. Mabanglo/EPA Several blockbuster drug patents are set to expire in the coming years, opening the door for cheaper generic competitors. To refill thinning pipelines, drugmakers are increasingly turning to biotech companies. British pharma giant GSK signed a licensing deal with Chinese biotech firm Hengrui Pharma last July. “Because of the increasing relevance of China, the big pharma industry and the U.K. by definition is now looking to China as a source of those new innovative therapies,” Farrelly said. There are already signs of progress. Science Minister Patrick Vallance said late last year that the U.K. and China are ready to work together in “uncontroversial” areas, including health, after talks with his Chinese counterpart. AstraZeneca, the University of Cambridge and Beijing municipal parties have already signed a partnership to share expertise. And earlier this year, the U.K. announced plans to become a “global first choice for clinical trials.” “The U.K. can really help China with the trust gap” when it comes to getting drugs onto the market, said Quin Wills, CEO of Ochre, a biotech company operating in New York, Oxford and Taiwan. “The U.K. could become a global gold stamp for China. We could be like a regulatory bridgehead where [healthcare regulator] MHRA, now separate from the EU since Brexit, can do its own thing and can maybe offer a 150-day streamlined clinical approval process for China as part of a broader agreement.” SLASHING WHISKY TARIFFS  The U.K. has also been pushing for lowered tariffs on whisky alongside wider agri-food market access, according to two of the industry figures familiar with the planning cited earlier. Talks at the end of 2024 between then-Trade Secretary Jonathan Reynolds and his Chinese counterpart ended Covid-era restrictions on exports, reopening pork market access. But in February 2025 China doubled its import tariffs on brandy and whisky, removing its provisional 5 percent tariff and applying the 10 percent most-favored-nation rate. “The whisky and brandy issue became China leverage,” said the senior British business representative briefed on the talks. “I think that they’re probably going to get rid of the tariff.”  It’s not yet clear how China would lower whisky tariffs without breaching World Trade Organization rules, which say it would have to lower its tariffs to all other countries too. INDUSTRIAL TENSIONS The trip comes as the U.K. faces growing international pressure to take a tougher line on Chinese industrial overproduction, particularly of steel and electric cars. But in February 2025 China doubled its import tariffs on brandy and whisky, removing its provisional 5 percent tariff and applying the 10 percent most-favored-nation rate. | Yonhap/EPA But while the U.K.’s allies in the European Union and the U.S. have imposed tariffs on Chinese EVs, the U.K. has resisted pressure to do so. There’s a deal “in the works” between Chinese EV maker and Jaguar Land Rover, said the senior British business representative briefed on the talks quoted higher, where the two are “looking for a big investment announcement. But nothing has been agreed.” The deal would see the Chinese EV maker use JLR’s factory in the U.K. to build cars in Britain, the FT reported last week. “Chinese companies are increasingly focused on localising their operations,” said another business representative familiar with the talks, noting Chinese EV makers are “realising that just flaunting their products overseas won’t be a sustainable long term model.” It’s unlikely Starmer will land a deal on heavy energy infrastructure, including wind turbine technology, that could leave Britain vulnerable to China. The U.K. has still not decided whether to let Ming Yang, a Chinese firm, invest £1.5 billion in a wind farm off the coast of Scotland.

MARSEILLE, France — Violence at a drug trafficking hotspot in the social housing complex next to Orange’s headquarters in Marseille forced the telecoms giant to lock its forest-green gates and order its thousands of employees to work from home. The disruption to such a recognizable company — one that gives its name to the city’s iconic football venue — became a fresh symbol of how drug trafficking and insecurity are reshaping politics ahead of municipal elections. In a recent poll, security ranked among voters’ top concerns, forcing candidates across the spectrum to pitch competing responses to the drug trade. “The number one theme is security,” center-right candidate Martine Vassal told POLITICO. “In the field, what I hear most often are people who tell me that they no longer travel in the heart of the city for that reason.” French political parties are watching the contest closely for clues about the broader battles building toward the 2027 presidential race. In many ways, Marseille is a microcosm of France as a whole, reflecting the country’s wider demographics and its biggest political battles. The city is diverse. Multicultural and low-income neighborhoods that tend to support the hard left abut conservative suburbs that have swung to the far right in recent years. As in much of France, support for the political center in Marseille is wobbling.  The left-wing incumbent Benoît Payan remains a slight favorite in the March contest, but Franck Allisio, the candidate for the far-right National Rally, is just behind, with both men polling at around 30 percent. The issues at play strike at the heart of Marseille’s identity: its notorious drug trade, entrenched poverty and failure to seize on the competitive advantages of a young, sun-drenched city strategically perched on the Mediterranean. Whichever candidate can articulate a platform that speaks to Marseille’s local realities while addressing anxieties shared across France will be well positioned to take city hall — and to provide their party with a potential blueprint for the 2027 presidential campaign.  SECOND CITY  Marseille has always had something of a little-brother complex with Paris, a resentment that goes beyond the football rivalry of Paris Saint-Germain and Olympique de Marseille. Many in the city regard the French capital as a distant power center that tries to impose its own solutions on Marseille without sufficiently consulting local experts.   People in Marseilles pay tribute to murdered Mehdi Kessaci. 20, whose brother is a prominent anti drug trafficking campaigner, and protest against trafficking, Nov. 22, 2025. | Clement Mahoudeau/AFP via Getty Images “Paris treats Marseille almost like a colony,” said Allisio. “A place you visit, make promises to — without any guarantee the money will ever be spent.”  When it comes to drug trafficking and security, leaders across the political spectrum agree that Paris is prescribing medicine that treats the symptoms of the crisis, not the cause.  Violence associated with the drug trade was thrust back in the spotlight in November with the killing of 20-year-old Mehdi Kessaci. Authorities are investigating the crime as an act of intimidation. Mehdi’s brother Amine Kessaci is one of the city’s most prominent anti-trafficking campaigners, rising to prominence after their half-brother — who was involved in the trade — was killed several years earlier.  President Emmanuel Macron, Interior Minister Laurent Nuñez and Justice Minister Gérald Darmanin all visited Marseille in the wake of Kessaci’s killing, outlining a tough-on-crime agenda to stop the violence and flow of drugs.  Locals stress that law-and-order investments must be matched with funding for public services. Unless authorities improve the sluggish economy that has encouraged jobless youths to turn to the drug trade, the problem will continue.  “Repression alone is not efficient,” said Kaouther Ben Mohamed, a former social worker turned activist. “If that was the case, the drug trade wouldn’t have flourished like it did.” Housing is another issue, with many impoverished residents living in dangerous, dilapidated buildings. “We live in a shit city,” said Mahboubi Tir, a tall, broad-shouldered young man with a rugby player’s physique. “We’re not safe here.”   Tir spent a month in a coma and several more in a hospital last April after he was assaulted during a parking dispute. His face was still swollen and distorted when he spoke to POLITICO in December about how the incident reshaped his relationship with the city he grew up in.  “I almost died, and I was angry at the city,” said Tir, who suffers from memory loss and has only a vague recollection of what led to the assault, as he sipped coffee in the backroom office of a tiny, left-leaning grassroots political party where he volunteers, Citizen Ambition.  SECURITY PROBLEM To what extent Marseille’s activist groups can bring about change in a city whose struggles have lasted for decades remains to be seen, but the four leading candidates for mayor share a similar diagnosis. They all believe the lurid crime stories making national headlines are a byproduct of a lack of jobs and neglected public services — and that the French state’s responses miss the mark. Rather than relying on harsher punishments as a deterrent, they argue the state should prioritize local policing and public investment. When Payan announced his candidacy for reelection, he pledged free meals for 15,000 students to get them back in school and to double the number of local cops as part of a push for more community policing. Allisio’s platform puts the emphasis on security-related spending: increased video surveillance, more vehicles for local police and the creation of “specialized units to combat burglary and public disorder.” Vassal — the center-right backed by the conservative Les Républicains and parties aligned with Macron — has similarly put forward a proposal to arm fare enforcers in public transport. Both Allisio and Vassal are calling for unspecified spending cuts while preserving basic services provided at the local level like schools, public transportation and parks and recreation. Vassal, who is polling third, said she would make public transportation free for residents younger 26 to travel across the spread-out city. She accuses the current administration of having delivered an insufficient number of building permits, slowing the development of new housing and office buildings and thus the revitalization of Marseille’s most embattled areas — a trend she pledged to reverse. Both Vassal and Allisio are advocating for less local taxes on property to boost small businesses and create new jobs. Allisio has also put forward a proposal to make parking for less 30 minutes free to facilitate deliveries and quick stops to buy products. The outlier — at least when it comes to public safety — is Sébastien Delogu, a disciple of three-time hard-left presidential candidate Jean-Luc Mélenchon. Though Delogu is polling fourth at 14 percent, he can’t be counted out, given that Mélenchon won Marseille in the first round of the last two presidential elections. Though Delogu acknowledges that crime is a problem, he doesn’t want to spend more money on policing. He instead proposes putting money that other candidates want to spend on security toward poverty reduction, housing supply and the local public health sector. Whoever wins, however, will have to grapple with an uncomfortable truth. Aside from local police responsible for public tranquility and health, policing and criminal justice matters are largely managed at the national level. The solution to Marseille’s problems will depend, to no small extent, on the outcome of what happens next year in Paris.

Pharmacies across the U.K. are reporting widespread shortages of aspirin, one of the most widely prescribed drugs that is used to prevent heart attacks and strokes and treat pain. From a survey of 540 pharmacies, 86 percent had been unable to supply the medication to their patients in the past week, the National Pharmacy Association said Friday. Pharmacies said they have been rationing supplies, prioritizing patients with the most acute heart conditions or in need of emergency prescriptions, with several saying they stopped selling the medication over the counter. Olivier Picard, chair of the NPA, said the association is “concerned” about these reports and its implications on patients; 51 million aspirin items were prescribed in the U.K. between January and October last year. “For those pharmacies that can get hold of supply, costs will far exceed what they will be reimbursed by the [National Health Service], yet more signs of a fundamentally broken pharmacy contract in desperate need of reform by the government,” Picard said. Earlier this month, U.S. President Donald Trump made headlines for saying he takes a high daily dose of aspirin as it’s “good for thinning out the blood, and I don’t want thick blood pouring through my heart.” He reportedly takes four times the recommended daily dose for cardiovascular disease prevention. On Thursday, Trump blamed the medication for his visible hand bruise at Davos. In the U.K., pharmacists cannot offer patients substitutions for a prescribed medication, such as a different strength or formulation, without a new doctor’s prescription. The government is looking into the possibility of changing this. “We’ve long called for pharmacists to be able to make substitutions where a medicine is not in stock and it is safe to supply an alternative,” he said. “The status quo is not only frustrating for patients, it is also dangerous.” The government added aspirin to its export ban list on Jan. 16 amid the ongoing shortage. In the EU, the Pharmaceutical Group of the European Union said Friday they “don’t have any signal regarding shortages of aspirin in the EU.” The European Medicines Agency, which monitors drugs in short supply, does not currently list aspirin.

U.S. President Donald Trump’s assertion that taking paracetamol during pregnancy is linked to autism in kids has been debunked by a large evidence review. Researchers say the new study published Saturday should put women at ease should they need to use these painkillers. Last year, Trump warned pregnant women against using Tylenol — a U.S. brand name for paracetamol — during pregnancy, arguing that its use “can be associated with a very increased risk of autism.” The position was driven by Republicans pushing the MAHA — Make America Healthy Again — movement led by U.S. Health Secretary Robert F. Kennedy Jr. But it has split politicians and health experts on both sides of the Atlantic and confused citizens. While the U.S. Food and Drug Administration ordered a new safety warning be added to Tylenol leaflets, the European Medicines Agency said at the time there was no evidence of a link between paracetamol use in pregnancy and autism. Medical professionals raised concerns that pregnant women would have no treatment for fever or pain, and may be vilified for the rise in autism in recent decades. Now, a large review of 43 studies, published in The Lancet Obstetrics, Gynaecology & Women’s Health, found there is no evidence of a link — contradicting the U.S. studies used to recommend against its use in the U.S. “We found no clinically important increase in the risk of autism, [attention deficit hyperactivity disorder (ADHD)] or intellectual disability of the children where the mothers took paracetamol during pregnancy,” said Asma Khalil, a consultant obstetrician and fetal medicine specialist at St George’s Hospital in London, who led the study. “The important message to the millions of pregnant individuals is the fact that actually paracetamol is safe to use in pregnancy,” she added. “It remains to be the first line of treatment that we would recommend if the pregnant woman has pain or fever in pregnancy.” While previous studies did suggest small associations between paracetamol in pregnancy and increased risks of autism and ADHD, the Lancet researchers said these were often based on studies prone to biases. In particular, the U.S. administration cited a study published last summer which found a link between paracetamol during pregnancy and increased incidence of neuro-developmental disorders (NDDs). But in this review “there are several studies [which] suffer or are vulnerable to bias,” Khalil said. “The potential implications of not accounting for these confounders is that you draw their own conclusions.” The Lancet’s evidence review instead focused on studies with the most rigorous research methods, such as those at low risk of bias, those with sibling comparisons and with at least five years of follow up — and found no link. In particular, sibling-comparison studies allow researchers to compare children born to the same mother, who only took paracetamol during one of the pregnancies. They take into account shared genetic factors, shared family and long-term parental characteristics. “Our findings suggest that previously reported links are likely to be explained by genetic predisposition or other maternal factors such as fever or underlying pain, rather than a direct effect of the paracetamol itself,” Khalil said. Public health experts, the EMA and the European Commission, pushed back against Trump’s position last year, arguing there was no evidence to support it. “While the impact of last year’s announcement has been extensive, I hope the findings of this study bring the matter to a close,” Grainne McAlonan, professor of translational neuroscience at King’s College London, said.  “Expectant mothers do not need the stress of questioning whether medicine most commonly used for a headache could have far reaching effects on their child’s health,” McAlonan said.

Faced with an ageing population and rising chronic disease rates, Europe wants to make its citizens healthier. It also needs to keep its most powerful industries happy. In the basket of health policies that EU lawmakers rushed to get across the line before Christmas, industry was the big winner: The pharmaceutical, food and drink sectors walked away with a set of major policy wins — and (potentially) healthier profits. While the pharma industry previously feared losing some of its monopoly rights on new drugs, the Commission this month offered it an extra year of patent protection for novel biotech drugs — among the most expensive treatments in the world. The food and drink sectors, meanwhile, successfully pushed back against proposals to tax ultra-processed foods and alcopops, for now. On Dec. 16 the Commission published its Biotech Act and Safe Hearts Plan, which landed just days after a long-awaited update of the pharmaceutical legislation. Taken together, they seek to incentivize industries to innovate and do business in Europe, improve access to medicines, and tackle the burden of cardiovascular disease. The pharma industry broadly celebrated the biotech proposal. The Biotech Act “reflects priorities we’ve intensively advocated to keep Europe globally competitive in life sciences,” Ognjenka Manojlovic, head of policy at European pharmaceutical company Sanofi, told POLITICO. That includes accelerating clinical trials, boosting intellectual property, and strengthening financing for Europe’s biotech ecosystem, Manojlovic said. The pharmaceutical sector had pushed for longer monopoly rights in the pharma legislation. In the end they were kept at the current standard eight years — instead of being cut by two years as the European Commission had initially proposed. For Europe’s public health insurers, who pay for drugs, the decisions taken to maintain and then extend market protections for medicines are hard to square. “We are puzzled by the Commission’s intentions,” said Yannis Natsis, director of the European Social Insurance Platform, a network of Europe’s social insurance organizations, warning that taxpayers will have to pick up the bill. Meanwhile, health campaigners are also unhappy at the Commission’s “missed opportunity” to tackle obesity and heart disease with junk food taxes — as proposed in an earlier draft of the Safe Hearts Plan. Samuele Tonello, at consumer organization BEUC, said the Safe Hearts Plan “lacks teeth” to better protect consumers from unhealthy foods, and flagged the “urgency of [cardiovascular diseases].”  A MAN ON A MISSION Health Commissioner Olivér Várhelyi has made no secret of his support for industry, and has championed the Commission’s competitiveness mantra since taking office in late 2024. Health Commissioner Olivér Várhelyi has made no secret of his support for industry, and has championed the Commission’s competitiveness mantra since taking office in late 2024. | Thierry Monasse/Getty Images The standout feature of his end-of-year bonanza was the 12-month patent extension in the Biotech Act I — legislation that was split in two late in the day, allowing Várhelyi to meet his end-of-year deadline for the pharma component. The proposal came just a week after the Commission, countries and MEPs clinched a deal to reform Europe’s pharmaceutical laws, in which IP rights were among the last issues to be settled. Updates to the pharma laws were a legacy of the last Commission, whereas the Biotech Act became something of a personal mission for Várhelyi. He repeatedly stressed that there was “no time to lose” in delivering a targeted policy aimed at revitalizing Europe’s flagging biotech industry, which risks being overtaken by competition from China and the U.S. Few commissioners are more vocal than Várhelyi about the premium they place on the competitiveness of European industry.  Industry insiders had heard whispers of his plans to expand IP incentives for the biotech sector, even if Council representatives were dismayed not to have been informed in advance — especially with the ink barely dry on the Pharma Package. That’s not to say pharma is happy with its lot. Industry lobby group the European Federation of Pharmaceutical Industries and Associations (EFPIA) tempered its praise of the Biotech Act, lamenting that the extra year of monopoly rights would only apply to a “limited subset of products.”  The extra year of protection is tied to the Commission’s efforts to locate more pharma research and manufacturing in Europe. It would apply only to new products, tested and at least partially made in Europe.  But the generics sector, which makes cheaper, off-patent drugs to compete with branded medicines, sees the Biotech Act as a further sweetening of what is already one of the world’s most generous IP systems. Lobby group Medicines for Europe claims each year of delayed competition for the top three biologic drugs would cost countries €7.7 billion. Longer IP “will have a dramatic impact on healthcare budgets and delayed patients’ access to essential medicines,” said Adrian van den Hoven, head of the lobby. These kinds of estimates would normally be included in an impact assessment published alongside the proposal, but in its haste to get the Biotech Act out the Commission didn’t do one. POLITICO asked the Commission for an estimate of what the extra year of patent protection would cost. A Commission spokesperson would not give a figure but said they had used the impact assessment for the pharma legislation as a reference. “It is also important to stress that the number of products eligible for an additional year of SPC will be limited to only those that are truly innovative and tested and manufactured in the EU. The approach is deliberately targeted to incentivise genuinely innovative therapies that deliver a clear added value for patients and support European innovation,” the spokesperson said. LUCKY ESCAPE FOR UPFS The big food and drink sectors are on shakier ground with Várhelyi. The commissioner has repeatedly made known his distaste for ultra-processed food, and an early leaked version of the Safe Hearts Plan included new taxes on unhealthy highly processed foods and alcopops. But the final proposal showed the Commission had undertaken a significant climbdown. Concrete targets to tax unhealthy food and drink in 2026 were gone, replaced with a much woollier commitment to “work towards” such a levy. Alcopops were excluded altogether.  Industry lobby FoodDrinkEurope took a far more measured tone on the final plan than its explosive reactions to the earlier leaks, but that may well ramp up again if and when health tax proposals emerge. The text suggests the soft drinks industry may be the Commission’s first target if it does decide to pursue new levies, while UPFs remain in Várhelyi’s sights. “In the next couple of years, we will need to tackle the issue of ultra-processed food much more,” he told MEPs in December. For now, though, the plan seems to have let industry off easy. Health NGOs saw it as a disappointment, given its lack of hard-hitting policies to reduce consumption of UPFs and other unhealthy products. While the pharma legislation is all wrapped up, the Biotech Act still needs to win the approval of EU countries and the European Parliament. For the food and pharma sectors, the proposals set out this month are confirmation they have allies in the Berlaymont.

Disclaimer POLITICAL ADVERTISEMENT * This is sponsored content from AstraZeneca. * The advertisement is linked to public policy debates on the future of cancer care in the EU. More information here. Europe has made huge strides in the fight against cancer.[1] Survival rates have climbed, detection has improved and the continent has become home to some of the world’s most respected research hubs.[2],[3] None of that progress came easy — it was built on years of political attention and cooperation across borders. However, as we look to 2026 and beyond, that progress stands at a crossroads. Budget pressures and tougher global competition threaten to push cancer and health care down the EU agenda. Europe’s Beating Cancer Plan — a flagship initiative aimed at expanding screening, improving early detection and boosting collaboration — is set to expire in 2027, with no clear plan to secure or extend its gains.[4],[5] “My [hope is that we can continue] the work started with Europe’s Beating Cancer Plan and make it sustainable… [and] build on the lessons learned, [for other disease areas] ” says Antonella Cardone, CEO of Cancer Patients Europe. A new era in cancer treatment Concern about the lapsing initiative is compounded by two significant shifts in health care: declining investment and increasing scientific advancement. Firstly, Europe has seen the increased adoption of cost-containment policies by some member states. Under-investment in Europe in cancer medicines has been a challenge — specifically with late and uneven funding, and at lower levels than international peers such as the US — potentially leaving patients with slower and more limited access to life-saving therapies.[6],[7],[8] Meanwhile, the U.S., which pays on average double for medicines per capita than the EU,[9] is actively working to rebalance its relationship with pharmaceuticals to secure better pricing (“fair market value”) through policies across consecutive administrations.[10] All the while, China is rapidly scaling investment in biotech and clinical research, determined to capture the trials, talent, and capital that once flowed naturally to Europe.[11] The rebalancing of health and life-science investment can have significant consequences. If Europe does not stay attractive for life-sciences investment, the impact will extend beyond cancer patient outcomes. Jobs, tax revenues, advanced manufacturing, and Europe’s leadership in strategic industries are all at stake.[12] Secondly, medical science has never looked more promising.[7] Artificial intelligence is accelerating drug discovery, clinical trials, and diagnostics, and the number of approved medicines for patients across Europe has jumped from an average of one per year between 1995 and 2000 to 14 per year between 2021 and 2024.[13],[14],[15], [7] Digital health tools and innovative medtech startups are multiplying, increasing competitiveness and lowering costs — guiding care toward a future that is more personalized and precise.[16],[17] Europe stands at the threshold of a new era in cancer treatment. But if policymakers ease up now, progress could stall — and other regions, especially the U.S. and China, are more than ready to widen the innovation gap. Recognizing the strategic investment Health spending is generally treated as a budget item to be contained. Yet investment in cancer care has been one of Europe’s smartest economic bets.[18],[19] The sector anchors millions of high-skilled jobs (it employs around 29 million people in the EU[11]) and attracts global life sciences investment. According to the European Commission, the sector contributes nearly €1.5 trillion to the EU economy.[12] Studies from the Institute of Health Economics confirm that money put into research directly translates into better survival outcomes.[20] The same report shows that although the overall spend on cancer is increasing, the cost per patient has actually decreased since 1995, suggesting that innovative treatments are increasing efficiency.[20] Those gains matter not only to patients and families, but to Europe’s long-term stability: healthier populations mean fewer costs down the line, stronger productivity, and more sustainable public finances.[20] Fixing Europe’s access gap Cancer medicines bring transformative value — to patients, to society and to the wider economy. [21] However, even as oncology therapies advance, patients across Europe are not benefiting equally. EFPIA’s 2024 Patients W.A.I.T. indicator shows that, on average, just 46 percent of innovative medicines approved between 2020 and 2023 were available to patients in 2024.[22] On average, it takes 578 days for a new oncology medicine to reach European patients, and only 29 percent of drugs are fully available in all member states.[23] This is not caused by a lack of breakthrough medicines, but by national policy mechanisms that undervalue innovation. OECD and the Institute for Health Economics data show that divergent HTA requirements, rigid cost-effectiveness thresholds, price-volume clawbacks, ad hoc taxes on pharmaceutical revenues and slow national reimbursement decisions collectively suppress timely access to new cancer medicines across the EU.[24] These disparities cut against Europe’s long-standing reputation as a collection of societies that values equitable, high-quality care for all of its citizens. It risks eroding one of the EU’s defining strengths: the commitment to fairness and collective progress. Cancer policy solutions for the EU Although this is ultimately a matter for member states, embedding cancer as a permanent EU priority — backed by funding, coordination, and accountability — could give national systems the incentives and strategic direction to buck these trends. These actions will reassure pharmaceutical companies that Europe is serious about attracting clinical trials and the launch of new medicines, ensuring that its citizens, societies and economies enjoy the benefits this brings. Europe’s Beating Cancer Plan delivered progress, but its expiry presents a pivotal moment. 2026 and beyond bring a significant opportunity for the EU to build on this by ensuring that member states implement National Cancer Control Plans and have clear targets and accountability on their national performance, including on investment and access. To do this, EU policymakers should consider three actions as an immediate priority with lasting impact: * Embed cancer and investment within EU governance. Build it into the European Semester on health with mandatory indicators, regular reviews, and accountability frameworks to ensure continuity. This model worked well during Covid-19 and should be adapted for non-communicable diseases starting with cancer as a pilot. * Secure stable and sufficient funding. The Multiannual Financial Framework must ensure adequate funding for health and cancer to encourage coordinated initiatives across member states. * Strengthen EU-level coordination. Ensure that pan-EU structures such as the Comprehensive Cancer Centres and Cancer Mission Hubs are adequately funded and empowered. These are the building blocks of a lasting European commitment to cancer. With action, Europe can secure a sustainable foundation for patients, resilience and continued scientific excellence. -------------------------------------------------------------------------------- [1] European Commission, OECD/European Observatory on Health Systems and Policies. 2023. State of Health in the EU: Synthesis Report 2023. Available at: https://health.ec.europa.eu/system/files/2023-12/state_2023_synthesis-report_en.pdf [Accessed December 2025] [2] Efpia. 2025. Cancer care 2025: an overview of cancer outcomes data across Europe. Available at: https://www.efpia.eu/news-events/the-efpia-view/statements-press-releases/ihe-cancer-comparator-report-2025/ [Accessed December 2025] [3] Cancer Core Europe. 2024. Cancer Core Europe: Advancing Cancer Care Through Collaboration. Available at: https://www.cancercoreeurope.eu/cce-advancing-cancer-care-collaboration/ [Accessed December 2025] [4] European Commission. 2021. Europe’s Beating Cancer Plan. Available at:https://health.ec.europa.eu/system/files/2022-02/eu_cancer-plan_en_0.pdf [Accessed December 2025] [5] European Parliament. 2025. Europe’s Beating Cancer Plan: Implementation findings. https://www.europarl.europa.eu/RegData/etudes/STUD/2025/765809/EPRS_STU(2025)765809_EN.pdf [Accessed December 2025] [6] Hofmarcher, T., et al. 2024. Access to Oncology Medicines in EU and OECD Countries (OECD Health Working Papers, No.170). OECD Publishing. Available at: https://www.oecd.org/content/dam/oecd/en/publications/reports/2024/09/access-to-oncology-medicines-in-eu-and-oecd-countries_6cf189fe/c263c014-en.pdf [Accessed December 2025] [7] Manzano, A., et al. 2025. Comparator Report on Cancer in Europe 2025 – Disease Burden, Costs and Access to Medicines and Molecular Diagnostics (IHE). Available at: https://ihe.se/app/uploads/2025/03/IHE-REPORT-2025_2_.pdf [Accessed December 2025] [8] Efpia. [no date]. Europe’s choice. Available at: https://www.efpia.eu/europes-choice/ [Accessed December 2025] [9] OECD. 2024. Prescription Drug Expenditure per Capita. https://data-explorer.oecd.org/vis?lc=en&pg=0&snb=1&vw=tb&df[ds]=dsDisseminateFinalDMZ&df[id]=DSD_SHA%40DF_SHA&df[ag]=OECD.ELS.HD&df[vs]=&pd=2015%2C&dq=.A.EXP_HEALTH.USD_PPP_PS%2BPT_EXP_HLTH._T..HC51%2BHC3.._T…&to[TIME_PERIOD]=false&lb=bt [Accessed December 2025] [10] The White House. 2025. Delivering most favored-nation prescription drug pricing to American patients. Available at: https://www.whitehouse.gov/presidential-actions/2025/05/delivering-most-favored-nation-prescription-drug-pricing-to-american-patients/ [Accessed December 2025] [11] Eleanor Olcott, Haohsiang Ko and William Sandlund. 2025. The relentless rise of China’s Biotechs. Financial Times. Available at: https://www.ft.com/content/c0a1b15b-84ee-4549-85eb-ed3341112ce5 [Accessed December 2025] [12] European Commission, Directorate-General for Communication. 2025. Making Europe a Global Leader in Life Sciences. Available at: https://commission.europa.eu/news-and-media/news/making-europe-global-leader-life-sciences-2025-07-02_en [Accessed December 2025] [13] Financial Times. 2025. How AI is reshaping drug discovery. Available at: https://www.ft.com/content/8c8f3c10-9c26-4e27-bc1a-b7c3defb3d95 [Accessed December 2025] [14] Seedblink. 2025. Europe’s HealthTech investment landscape in 2025: A deep dive. https://seedblink.com/blog/2025-05-30-europes-healthtech-investment-landscape-in-2025-a-deep-dive [15] European Commission. [No date]. Artificial Intelligence in healthcare. Available at: https://health.ec.europa.eu/ehealth-digital-health-and-care/artificial-intelligence-healthcare_en [Accessed December 2025] [16] Codina, O. 2025. Code meets care: 20 European HealthTech startups to watch in 2025 and beyond. EU-Startups. Available at: https://www.eu-startups.com/2025/06/code-meets-care-20-european-healthtech-startups-to-watch-in-2025-and-beyond [Accessed December 2025] [17] Protogiros et al. 2025. Achieving digital transformation in cancer care across Europe: Practical recommendations from the TRANSiTION project. Journal of Cancer Policy. Available at: https://www.sciencedirect.com/science/article/pii/S2213538325000281 [Accessed December 2025] [18] R-Health Consult. [no date]. The case for investing in a healthier future for the European Union. EFPIA. Available at: https://www.efpia.eu/media/xpkbiap5/the-case-for-investing-in-a-healthier-future-for-the-european-union.pdf [Accessed December 2025] [19] Pousette A., Hofmarcher T. 2024.Tackling inequalities in cancer care in the European Union. Available at: https://ihe.se/en/rapport/tackling-inequalities-in-cancer-care-in-the-european-union-2/ [Accessed December 2025] [20] Efpia. 2025. Comparator Report Cancer in Europe 2025. Available at: https://www.efpia.eu/media/0fbdi3hh/infographic-comparator-report-cancer-in-europe.pdf [Accessed December 2025] [21] Garau, E. et al. 2025. The Transformative Value of Cancer Medicines in Europe. Dolon Ltd. Available at: https://dolon.com/wp-content/uploads/2025/09/EOP_Investment-Value-of-Oncology-Medicines-White-Paper_2025-09-19-vF.pdf?x16809 [Accessed December 2025] [22] IQVIA. 2025. EFPIA Patients W.A.I.T. Indicator 2024 Survey. Available at: https://www.efpia.eu/media/oeganukm/efpia-patients-wait-indicator-2024-final-110425.pdf [Accessed December 2025] [23] Visentin M. 2025. Improving equitable access to medicines in Europe must remain a priority. The Parliament. Available at: https://www.theparliamentmagazine.eu/partner/article/improving-equitable-access-to-medicines-in-europe-must-remain-a-priority [Accessed December 2025] [24] Hofmarcher, T. et al. 2025. Access to novel cancer medicines in Europe: inequities across countries and their drivers. ESMO Open. Available at: https://www.esmoopen.com/action/showPdf?pii=S2059-7029%2825%2901679-5 [Accessed December 2025]

Thirty-six million Europeans — including more than one million in the Nordics[1] — live with a rare disease.[2] For patients and their families, this is not just a medical challenge; it is a human rights issue. Diagnostic delays mean years of worsening health and needless suffering. Where treatments exist, access is far from guaranteed. Meanwhile, breakthroughs in genomics, AI and targeted therapies are transforming what is possible in health care. But without streamlined systems, innovations risk piling up at the gates of regulators, leaving patients waiting. Even the Nordics, which have some of the strongest health systems in the world, struggle to provide fair and consistent access for rare-disease patients. Expectations should be higher. THE BURDEN OF DELAY The toll of rare diseases is profound. People living with them report health-related quality-of-life scores 32 percent lower than those without. Economically, the annual cost per patient in Europe — including caregivers — is around €121,900.[3] > Across Europe, the average time for diagnosis is six to eight years, and > patients continue to face long waits and uneven access to medications. In Sweden, the figure is slightly lower at €118,000, but this is still six times higher than for patients without a rare disease. Most of this burden (65 percent) is direct medical costs, although non-medical expenses and lost productivity also weigh heavily. Caregivers, for instance, lose almost 10 times more work hours than peers supporting patients without a rare disease.[4] This burden can be reduced. European patients with access to an approved medicine face average annual costs of €107,000.[5] Yet delays remain the norm. Across Europe, the average time for diagnosis is six to eight years, and patients continue to face long waits and uneven access to medications. With health innovation accelerating, each new therapy risks compounding inequity unless access pathways are modernized. PROGRESS AND REMAINING BARRIERS Patients today have a better chance than ever of receiving a diagnosis — and in some cases, life-changing therapies. The Nordics in particular are leaders in integrated research and clinical models, building world-class diagnostics and centers of excellence. > Without reform, patients risk being left behind. But advances are not reaching everyone who needs them. Systemic barriers persist: * Disparities across Europe: Less than 10 percent of rare-disease patients have access to an approved treatment.[6] According to the Patients W.A.I.T. Indicator (2025), there are stark differences in access to new orphan medicines (or drugs that target rare diseases).[7] Of the 66 orphan medicines approved between 2020 and 2023, the average number available across Europe was 28. Among the Nordics, only Denmark exceeded this with 34. * Fragmented decision-making: Lengthy health technology assessments, regional variation and shifting political priorities often delay or restrict access. Across Europe, patients wait a median of 531 days from marketing authorization to actual availability. For many orphan drugs, the wait is even longer. In some countries, such as Norway and Poland, reimbursement decisions take more than two years, leaving patients without treatment while the burden of disease grows.[8] * Funding gaps: Despite more therapies on the market and greater technology to develop them, orphan medicines account for just 6.6 percent of pharmaceutical budgets and 1.2 percent of health budgets in Europe. Nordic countries — Sweden, Norway and Finland — spend a smaller share than peers such as France or Belgium. This reflects policy choices, not financial capacity.[9] If Europe struggles with access today, it risks being overwhelmed tomorrow. Rare-disease patients — already facing some of the longest delays — cannot afford for systems to fall farther behind. EASING THE BOTTLENECKS Policymakers, clinicians and patient advocates across the Nordics agree: the science is moving faster than the systems built to deliver it. Without reform, patients risk being left behind just as innovation is finally catching up to their needs. So what’s required? * Governance and reforms: Across the Nordics, rare-disease policy remains fragmented and time-limited. National strategies often expire before implementation, and responsibilities are divided among ministries, agencies and regional authorities. Experts stress that governments must move beyond pilot projects to create permanent frameworks — with ring-fenced funding, transparent accountability and clear leadership within ministries of health — to ensure sustained progress. * Patient organizations: Patient groups remain a driving force behind awareness, diagnosis and access, yet most operate on short-term or volunteer-based funding. Advocates argue that stable, structural support — including inclusion in formal policy processes and predictable financing — is critical to ensure patient perspectives shape decision-making on access, research and care pathways. * Health care pathways: Ann Nordgren, chair of the Rare Disease Fund and professor at Karolinska Institutet, notes that although Sweden has built a strong foundation — including Centers for Rare Diseases, Advanced Therapy (ATMP) and Precision Medicine Centers, and membership in all European Reference Networks — front-line capacity remains underfunded. “Government and hospital managements are not providing  resources to enable health care professionals to work hands-on with diagnostics, care and education,” she explains. “This is a big problem.” She adds that comprehensive rare-disease centers, where paid patient representatives collaborate directly with clinicians and researchers, would help bridge the gap between care and lived experience. * Research and diagnostics: Nordgren also points to the need for better long-term investment in genomic medicine and data infrastructure. Sweden is a leader in diagnostics through Genomic Medicine Sweden and SciLifeLab, but funding for advanced genomic testing, especially for adults, remains limited. “Many rare diseases still lack sufficient funding for basic and translational research,” she says, leading to delays in identifying genetic causes and developing targeted therapies. She argues for a national health care data platform integrating electronic records, omics (biological) data and patient-reported outcomes — built with semantic standards such as openEHR and SNOMED CT — to enable secure sharing, AI-driven discovery and patient access to their own data DELIVERING BREAKTHROUGHS Breakthroughs are coming. The question is whether Europe will be ready to deliver them equitably and at speed, or whether patients will continue to wait while therapies sit on the shelf. There is reason for optimism. The Nordic region has the talent, infrastructure and tradition of fairness to set the European benchmark on rare-disease care. But leadership requires urgency, and collaboration across the EU will be essential to ensure solutions are shared and implemented across borders. The need for action is clear: * Establish long-term governance and funding for rare-disease infrastructure. * Provide stable, structural support for patient organizations. * Create clearer, better-coordinated care pathways. * Invest more in research, diagnostics and equitable access to innovative treatments. Early access is not only fair — it is cost-saving. Patients treated earlier incur lower indirect and non-medical costs over time.[10] Inaction, by contrast, compounds the burden for patients, families and health systems alike. Science will forge ahead. The task now is to sustain momentum and reform systems so that no rare-disease patient in the Nordics, or anywhere in Europe, is left waiting. -------------------------------------------------------------------------------- [1] https://nordicrarediseasesummit.org/wp-content/uploads/2025/02/25.02-Nordic-Roadmap-for-Rare-Diseases.pdf [2] https://nordicrarediseasesummit.org/wp-content/uploads/2025/02/25.02-Nordic-Roadmap-for-Rare-Diseases.pdf [3] https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf [4] https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf [5] https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf [6] https://www.theparliamentmagazine.eu/partner/article/a-competitive-and-innovationled-europe-starts-with-rare-diseases? [7] https://www.iqvia.com/-/media/iqvia/pdfs/library/publications/efpia-patients-wait-indicator-2024.pdf [8] https://www.iqvia.com/-/media/iqvia/pdfs/library/publications/efpia-patients-wait-indicator-2024.pdf [9] https://copenhageneconomics.com/wp-content/uploads/2025/09/Copenhagen-Economics_Spending-on-OMPs-across-Europe.pdf [10] https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Alexion Pharmaceuticals * The entity ultimately controlling the sponsor: AstraZeneca plc * The political advertisement is linked to policy advocacy around rare disease governance, funding, and equitable access to diagnosis and treatment across Europe More information here.

This article is presented by EFPIA with the support of AbbVie I made a trip back to Europe recently, where I spent the vast majority of my pharmaceutical career, to share my perspectives on competitiveness at the European Health Summit. Now that I work in a role responsible for supporting patient access to medicine globally, I view Europe, and how it compares internationally, through a new lens, and I have been reflecting further on why the choices made today will have such a critical impact on where medicines are developed tomorrow. Today, many patients around the world benefit from medicines built on European science and breakthroughs of the last 20 years. Europeans, like me, can be proud of this contribution. As I look forward, my concern is that we may not be able to make the same claim in the next 20 years. It’s clear that Europe has a choice. Investing in sustainable medicines growth and other enabling policies will, I believe, bring significant benefits. Not doing so risks diminishing global influence. > Today, many patients around the world benefit from medicines built on European > science and breakthroughs of the last 20 years I reflect on three important points: 1) investment in healthcare benefits individuals, healthcare and society, but the scale of this benefit remains underappreciated; 2) connected to this, the underpinning science for future innovation is increasingly happening elsewhere; and 3) this means the choices we make today must address both of these trends. First, let’s use the example of migraine. As I have heard a patient say, “Migraine will not kill you but neither [will they] let you live.”[1] Individuals can face being under a migraine attack for more than half of every month, unable to leave home, maintain a job and engage in society.[2] It is the second biggest cause of disability globally and the first among young women.[3] It affects the quality of life of millions of Europeans.[4] From 2011-21 the economic burden of migraine in Europe due to the loss of working days ranged from €35-557 billion, depending on the country, representing 1-2 percent of gross domestic product (GDP).[5]   Overall socioeconomic burden of migraine as percentage of the country’s GDP in 2021 Source: WifOR, The socioeconomic burden of migraine. The case of 6 European Countries.5 Access to effective therapies could radically improve individuals’ lives and their ability to return to work.[6] Yet, despite the staggering economic and personal impacts, in some member states the latest medicines are either not reimbursed or only available after several treatment failures.[7] Imagine if Europe shifted its perspective on these conditions, investing to improve not only health but unlocking the potential for workforce and economic productivity? Moving to my second point, against this backdrop of underinvestment, where are scientific advances now happening in our sector? In recent years it is impressive to see China has become the second-largest drug developer in the world,[8] and within five years it may lead the innovative antibodies therapeutics sector,[9] which is particularly promising for complex areas like oncology. Cancer is projected to become the leading cause of death in Europe by 2035,[10] yet the continent’s share of the number of oncology trials dropped from 41 percent in 2013 to 21 percent in 2023.10 Today, antibody-drug conjugates are bringing new hope in hard-to-treat tumor types,[11] like ovarian,[12] lung[13] and colorectal[14] cancer, and we hope to see more of these advances in the future. Unfortunately, Europe is no longer at the forefront of the development of these innovations. This geographical shift could impact high-quality jobs, the vitality of Europe’s biotech sector and, most importantly, patients’ outcomes. [15] > This is why I encourage choices to be made that clearly signal the value > Europe attaches to medicines This is why I encourage choices to be made that clearly signal the value Europe attaches to medicines. This can be done by removing national cost-containment measures, like clawbacks, that are increasingly eroding the ability of companies to invest in European R&D. To provide a sense of their impact, between 2012 and 2023, clawbacks and price controls reduced manufacturer revenues by over €1.2 billion across five major EU markets, corresponding to a loss of 4.7 percent in countries like Spain.[16] Moreover, we should address health technology assessment approaches in Europe, or mandatory discount policies, which are simply not adequately accounting for the wider societal value of medicines, such as in the migraine example, and promoting a short-term approach to investment. By broadening horizons and choosing a long-term investment strategy for medicines and the life science sector, Europe will not only enable this strategic industry to drive global competitiveness but, more importantly, bring hope to Europeans suffering from health conditions. AbbVie SA/NV – BE-ABBV-250177 (V1.0) – December 2025 -------------------------------------------------------------------------------- [1] The Parliament Magazine, https://www.theparliamentmagazine.eu/partner/article/unmet-medical-needs-and-migraine-assessing-the-added-value-for-patients-and-society, Last accessed December 2025. [2] The Migraine Trust; https://migrainetrust.org/understand-migraine/types-of-migraine/chronic-migraine/, Last accessed December 2025. [3] Steiner TJ, et al; Lifting The Burden: the Global Campaign against Headache. Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019. J Headache Pain. 2020 Dec 2;21(1):137 [4] Coppola G, Brown JD, Mercadante AR, Drakeley S, Sternbach N, Jenkins A, Blakeman KH, Gendolla A. The epidemiology and unmet need of migraine in five european countries: results from the national health and wellness survey. BMC Public Health. 2025 Jan 21;25(1):254. doi: 10.1186/s12889-024-21244-8. [5] WifOR. Calculating the Socioeconomic Burden of Migraine: The Case of 6 European Countries. Available at: [https://www.wifor.com/en/download/the-socioeconomic-burden-of-migraine-the-case-of-6-eu­ropean-countries/?wpdmdl=358249&refresh=687823f915e751752703993]. Accessed June 2025. [6] Seddik AH, Schiener C, Ostwald DA, Schramm S, Huels J, Katsarava Z. Social Impact of Prophylactic Migraine Treatments in Germany: A State-Transition and Open Cohort Approach. Value Health. 2021 Oct;24(10):1446-1453. doi: 10.1016/j.jval.2021.04.1281 [7] Moisset X, Demarquay G, et al., Migraine treatment: Position paper of the French Headache Society. Rev Neurol (Paris). 2024 Dec;180(10):1087-1099. doi: 10.1016/j.neurol.2024.09.008. [8] The Economist, https://www.economist.com/china/2025/11/23/chinese-pharma-is-on-the-cusp-of-going-global, Last accessed December 2025. [9] Crescioli S, Reichert JM. Innovative antibody therapeutic development in China compared with the USA and Europe. Nat Rev Drug Discov. Published online November 7, 2025. [10] Manzano A., Svedman C., Hofmarcher T., Wilking N.. Comparator Report on Cancer in Europe 2025 – Disease Burden, Costs and Access to Medicines and Molecular Diagnostics. EFPIA, 2025. [IHE REPORT 2025:2, page 20] [11] Armstrong GB, Graham H, Cheung A, Montaseri H, Burley GA, Karagiannis SN, Rattray Z. Antibody-drug conjugates as multimodal therapies against hard-to-treat cancers. Adv Drug Deliv Rev. 2025 Sep;224:115648. doi: 10.1016/j.addr.2025.115648. Epub 2025 Jul 11. PMID: 40653109.. [12] Narayana, R.V.L., Gupta, R. Exploring the therapeutic use and outcome of antibody-drug conjugates in ovarian cancer treatment. Oncogene 44, 2343–2356 (2025). https://doi.org/10.1038/s41388-025-03448-3 [13] Coleman, N., Yap, T.A., Heymach, J.V. et al. Antibody-drug conjugates in lung cancer: dawn of a new era?. npj Precis. Onc. 7, 5 (2023). https://doi.org/10.1038/s41698-022-00338-9 [14] Wang Y, Lu K, Xu Y, Xu S, Chu H, Fang X. Antibody-drug conjugates as immuno-oncology agents in colorectal cancer: targets, payloads, and therapeutic synergies. Front Immunol. 2025 Nov 3;16:1678907. doi: 10.3389/fimmu.2025.1678907. PMID: 41256852; PMCID: PMC12620403. [15] EFPIA, Improving EU Clinical Trials: Proposals to Overcome Current Challenges and Strengthen the Ecosystem, efpias-list-of-proposals-clinical-trials-15-apr-2025.pdf, Last accessed December 2025. [16] The EU General Pharmaceutical Legislation & Clawbacks, © Vital Transformation BVBA, 2024.