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.
Tag - Patients
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.
After more than three decades in the pharmaceutical industry, I know one thing:
science transforms lives, but policy determines whether innovation thrives or
stalls. That reality shapes outcomes for patients — and for Europe’s
competitiveness. Today, Europeans stand at a defining moment. The choices we
make now will determine whether Europe remains a global leader in life sciences
or we watch that leadership slip away.
It’s worth reminding ourselves of the true value of Europe’s life sciences
industry and the power we have as a united bloc to protect it as a European
good.
Europe has an illustrious track record in medical discovery, from the first
antibiotics to the discovery of DNA and today’s advanced biologics. Still today,
our region remains an engine of medical breakthroughs, powered by an
extraordinary ecosystem of innovators in the form of start-ups, small and
medium-sized enterprises, academic labs, and university hospitals. This strength
benefits patients through access to clinical trials and cutting-edge treatments.
It also makes life sciences a strategic pillar of Europe’s economy.
The economic stakes
Life sciences is not just another industry for Europe. It’s a growth engine, a
source of resilience and a driver of scientific sovereignty. The EU is already
home to some of the world’s most talented scientists, thriving academic
institutions and research clusters, and a social model built on universal access
to healthcare. These assets are powerful, yet they only translate into future
success if supported by a legislative environment that rewards innovation.
> Life sciences is not just another industry for Europe. It’s a growth engine, a
> source of resilience and a driver of scientific sovereignty.
This is also an industry that supports 2.3 million jobs and contributes over
€200 billion to the EU economy each year — more than any other sector. EU
pharmaceutical research and development spending grew from €27.8 billion in 2010
to €46.2 billion in 2022, an average annual increase of 4.4 percent. A success
story, yes — but one under pressure.
While Europe debates, others act
Over the past two decades, Europe has lost a quarter of its share of global
investment to other regions. This year — for the first time — China overtook
both the United States and Europe in the number of new molecules discovered.
China has doubled its share of industry sponsored clinical trials, while
Europe’s share has halved, leaving 60,000 European patients without the
opportunity to participate in trials of the next generation of treatments.
Why does this matter? Because every clinical trial site that moves elsewhere
means a patient in Europe waits longer for the next treatment — and an ecosystem
slowly loses competitiveness.
Policy determines whether innovation can take root. The United States and Asia
are streamlining regulation, accelerating approvals and attracting capital at
unprecedented scale. While Europe debates these matters, others act.
A world moving faster
And now, global dynamics are shifting in unprecedented ways. The United States’
administration’s renewed push for a Most Favored Nation drug pricing policy —
designed to tie domestic prices to the lowest paid in developed markets —
combined with the potential removal of long-standing tariff exemptions for
medicines exported from Europe, marks a historic turning point.
A fundamental reordering of the pharmaceutical landscape is underway. The
message is clear: innovation competitiveness is now a geopolitical priority.
Europe must treat it as such.
A once-in-a-generation reset
The timing couldn’t be better. As we speak, Europe is rewriting the
pharmaceutical legislation that will define the next 20 years of innovation.
This is a rare opportunity, but only if reforms strengthen, rather than weaken,
Europe’s ability to compete in life sciences.
To lead globally, Europe must make choices and act decisively. A triple A
framework — attract, accelerate, access — makes the priorities clear:
* Attract global investment by ensuring strong intellectual property
protection, predictable regulation and competitive incentives — the
foundations of a world-class innovation ecosystem.
* Accelerate the path from science to patients. Europe’s regulatory system must
match the speed of scientific progress, ensuring that breakthroughs reach
patients sooner.
* Ensure equitable and timely access for all European patients. No innovation
should remain inaccessible because of administrative delays or fragmented
decision-making across 27 systems.
These priorities reinforce each other, creating a virtuous cycle that
strengthens competitiveness, improves health outcomes and drives sustainable
growth.
> Europe has everything required to shape the future of medicine: world-class
> science, exceptional talent, a 500-million-strong market and one of the most
> sophisticated pharmaceutical manufacturing bases in the world.
Despite flat or declining public investment in new medicines across most member
states over the past 20 years, the research-based pharmaceutical industry has
stepped up, doubling its contributions to public pharmaceutical expenditure from
12 percent to 24 percent between 2018 and 2023. In effect, we have financed our
own innovation. No other sector has done this at such scale. But this model is
not sustainable. Pharmaceutical innovation must be treated not as a cost to
contain, but as a strategic investment in Europe’s future.
The choice before us
Europe has everything required to shape the future of medicine: world-class
science, exceptional talent, a 500-million-strong market and one of the most
sophisticated pharmaceutical manufacturing bases in the world.
What we need now is an ambition equal to those assets.
If we choose innovation, we secure Europe’s jobs, research and competitiveness —
and ensure European patients benefit first from the next generation of medical
breakthroughs. A wrong call will be felt for decades.
The next chapter for Europe is being written now. Let us choose the path that
keeps Europe leading, competing and innovating: for our economies, our societies
and, above all, our patients. Choose Europe.
--------------------------------------------------------------------------------
Disclaimer
POLITICAL ADVERTISEMENT
* The sponsor is European Federation of Pharmaceutical Industries and
Associations (EFPIA)
* The ultimate controlling entity is European Federation of Pharmaceutical
Industries and Associations (EFPIA)
* The political advertisement is linked to the Critical Medicines Act.
More information here.
Rick Pazdur, the FDA’s top drug regulator, told staff Tuesday he submitted his
resignation to the agency, an abrupt departure weeks after he was convinced by
Commissioner Marty Makary to take the post to help bring stability to an agency
reeling from months of upheaval, according to four people familiar with the
decision granted anonymity to discuss the move.
The decision — which comes days after top vaccine regulator Vinay Prasad said
the agency would ratchet up regulatory requirements for new vaccines — is almost
certain to raise new questions about Makary’s leadership of the FDA.
Pazdur in recent weeks clashed with Makary over the Commissioner’s National
Priority Voucher program, according to media reports.
That program — which aims to speed final review of drugs that address health
priorities, pose a transformative innovative impact, address an unmet medical
need, help onshoring efforts or increase affordability — was also criticized by
Pazdur’s predecessor, George Tidmarsh. FDA experts have worried the involvement
of political appointees in the process of choosing which firms receive a voucher
could raise questions about the program’s integrity.
STAT first reported the news of Pazdur’s decision to retire. It is unclear if
the decision is final — one person familiar with the decision said the longtime
cancer drug regulator has 30 days to change his decision.
“We respect Dr. Pazdur’s decision to retire and honor his 26 years of
distinguished service at the FDA,” an FDA spokesperson said in a statement. “As
the founding director of the Oncology Center of Excellence, he leaves a legacy
of cross-center regulatory innovation that strengthened the agency and advanced
care for countless patients. His leadership, vision, and dedication will
continue to shape the FDA for years to come.”
The White House and Pazdur did not immediately respond to requests for comment.
Pazdur, a 26-year agency veteran, initially rebuffed efforts by Makary to
convince him to assume leadership of the FDA’s Center for Drug Evaluation and
Research — but ultimately agreed to take the job after being assured he would be
given autonomy in the role free from political influence and the ability to
rehire staff.
LONDON — The U.K. has agreed to raise how much its National Health Service
spends on new drugs, in a concession made under pressure from the Trump
administration in return for tariff-free access to the U.S. market.
“Today’s agreement is a major win for American workers and our innovation
economy,” U.S. Commerce Secretary Howard Lutnick said in a statement on Monday.
“This deal doesn’t just deepen our economic partnership with the United Kingdom
— it ensures that the breakthroughs of tomorrow will be built, tested, and
produced on American soil.”
The deal will see Britain increase the National Institute for Health and Care
Excellence (NICE) cost-effectiveness threshold by 25 percent, as POLITICO first
reported in October, and slash the cap on revenue the NHS can reclaim from
drugmakers to no more than 15 percent.
The new NICE threshold will be £25,000 to £35,000 per quality adjusted life year
gained over and above current treatments. The U.S. said the combined changes
would increase the net price the NHS pays for new medicines by 25 percent.
In exchange, the administration will grant an exemption for U.K.-made
pharmaceuticals, ingredients and medical technology from U.S. tariffs for the
remainder of President Donald Trump’s term.
U.K. Business and Trade Secretary Peter Kyle said: “This deal guarantees that UK
pharmaceutical exports – worth at least £5 billion a year – will enter the US
tariff free, protecting jobs, boosting investment and paving the way for the UK
to become a global hub for life sciences.
“We will continue to build on the UK-US Economic Prosperity Deal, and the
record-breaking investments we secured during the US State Visit, to create jobs
and raise living standards as part of our Plan for Change.”
The breakthrough comes after months of back-and-forth between both sides, with
the sector not covered in the Economic Prosperity Deal and Washington demanding
a “preferential environment” to lift the threat of steep import duties. The
administration had threatened to impose up to 100 percent tariffs on drugs.
In July, the President issued a letter to 17 drugmakers, demanding they offer
their drugs to Medicaid at most-favored-nation prices, prices tied to lower
prices abroad, and shift manufacturing to U.S. soil.
Update: This story has been updated following confirmation from the U.S. and
U.K. governments.
As Europe redefines its life sciences and biotech agenda, one truth stands out:
the strength of our innovation lies in its interconnection between human and
animal health, science and society, and policy and practice. This spirit of
collaboration guided the recent “Innovation for Animal Health: Advancing
Europe’s Life Sciences Agenda” policy breakfast in Brussels, where leading
voices from EU politics, science and industry came together to discuss how
Europe can turn its scientific excellence into a truly competitive and connected
life sciences ecosystem.
Jeannette Ferran Astorga / Via Zoetis
Europe’s role in life sciences will depend on its ability to see innovation
holistically. At Zoetis we firmly believe that animal health innovation must be
part of that equation, as this strengthens resilience, drives sustainability,
and connects directly to the wellbeing of people.
Innovation without barriers
Some of humanity’s greatest challenges continue to emerge at the intersection of
human, animal and environmental health, sometimes with severe economic impact.
The recent outbreaks of diseases like avian influenza, African swine fever and
bluetongue virus act as reminders of this. By enhancing the health and welfare
of animals, the animal health industry and veterinarians are strengthening
farmers’ livelihoods, supporting thriving communities and safeguarding global
food security. This is also contributing to protecting wildlife and ecosystems.
Meanwhile, companion animals are members of approximately half of European
households. Here, we have seen how dogs and cats have become part of the family,
with owners now investing a lot more to keep their pets healthy and able to live
to an old age. Because of the deepening bonds with our pets and their increased
longevity, the demand for new treatment alternatives is rising continuously,
stimulating new research and innovative solutions making their way into
veterinary practices. Zoonotic diseases that can be transferred between animals
and humans, like rabies, Lyme disease, Covid-19 and constantly new emerging
infectious diseases, make the rapid development of veterinary solutions a
necessity.
Throughout the world, life sciences are an engine of growth and a foundation of
health, resilience and sustainability. Europe’s next chapter in this field will
also be written by those who can bridge human and animal health, transforming
science into solutions that deliver both economic and societal value. The same
breakthroughs that protect our pets and livestock underpin the EU’s ambitions on
antimicrobial resistance, food security and sustainable agriculture.
Ensuring these innovations can reach the market efficiently is therefore not a
niche issue, it is central to Europe’s strategic growth and competitiveness.
This was echoed at the policy event by Dr. Wiebke Jansen, Policy Lead at the
Federation of Veterinarians of Europe (FVE) when she noted that ‘innovation is
not abstract. As soon as a product is available, it changes the lives of
animals, their veterinarians and the communities we serve. With the many unmet
needs we still face in animal health, having access to new innovation is an
extremely relevant question from the veterinary perspective.’
Enabling innovation through smart regulation
To realize the promise of Europe’s life sciences and biotech agenda, the EU must
ensure that regulation keeps pace with scientific discovery. The European
Commission’s Omnibus Simplification Package offers a valuable opportunity to
create a more innovation-friendly environment, one where time and resources can
be focused on developing solutions for animal and human health, not on
navigating overlapping reporting requirements or dealing with an ever increasing
regulatory burden.
> In animal health, biotechnology is already transforming what’s possible — for
> example, monoclonal antibodies that help control certain chronic conditions or
> diseases with unprecedented precision.
Reviewing legislative frameworks, developing the Union Product Database as a
true one-stop hub or introducing digital tools such as electronic product
information (e-leaflets) in all member states, for instance, would help
scientists and regulators alike to work more efficiently, thereby enhancing the
availability of animal health solutions. This is not about loosening standards;
it is about creating the right conditions for innovation to thrive responsibly
and efficiently.
Science that serves society
Europe’s leadership in life sciences depends on its ability to turn cutting-edge
research into real-world impact, for example through bringing new products to
patients faster. In animal health, biotechnology is already transforming what’s
possible — for example, monoclonal antibodies that help control certain chronic
conditions or diseases with unprecedented precision. Relieving itching caused by
atopic dermatitis or alleviating the pain associated with osteoarthritis
significantly increases the quality of life of cats and dogs — and their owners.
In addition, diagnostics and next-generation vaccines prevent outbreaks before
they start or spread further.
Maintaining a proportionate, benefit–risk for veterinary medicines allows
innovation to progress safely while ensuring accelerated access to new
treatments. Supporting science-based decision-making and investing in the
European Medicines Agency’s capacity to deliver efficient, predictable processes
will help Europe remain a trusted partner in global health innovation.
Continuum of Care / Via Zoetis
A One Health vision for the next decade
Europe is not short of ambition. The EU Biotech Act and the Life Sciences
Strategy both aim to turn innovation into a driver of growth and wellbeing. But
to truly unlock their potential, they must include animal health in their
vision. The experience of the veterinary medicines sector shows that innovation
does not stop at species’ borders; advances in immunology, monoclonal antibodies
and the use of artificial intelligence benefit both animals and humans.
A One Health perspective, where veterinary and human health research reinforce
each other, will help Europe to play a positive role in an increasingly
competitive global landscape. The next five years will be decisive. By fostering
proportionate, science-based adaptive regulation, investing in digital and
institutional capacity, and embracing a One Health approach to innovation,
Europe can become a genuine world leader in life sciences — for people and the
animals that are essential to our lives.
--------------------------------------------------------------------------------
Disclaimer
POLITICAL ADVERTISEMENT
* The sponsor is Zoetis Belgium S.A.
* The political advertisement is linked to policy advocacy on the EU
End-of-Life Vehicles Regulation (ELVR), circular plastics, chemical
recycling, and industrial competitiveness in Europe.
More information here.
With multiple legislative processes underway, we are now in an important moment
for Europe’s ambition to boost access and be a global leader in innovation. An
agile, modernized regulatory system — coupled with supportive intellectual
property and access policies — can attract research and development and advanced
manufacturing to Europe. This will contribute to the earlier availability of new
cures for European patients and a healthier innovative ecosystem.
Unfortunately, today we see that Europe is falling behind global competition.
Over the last decade, there has been a 10 percent decrease in clinical trials in
the European Union, which has led to 60,000 fewer European patients
participating in trials.[1] Europe’s fragmented system for clinical trial
approvals is a leading cause of this decline, impacting early access to
innovative treatments. As scientific breakthroughs can deliver better health
outcomes for patients, governments need to keep pace with this speed of
innovation.
> Draghi report on EU competitiveness importantly identified pharmaceutical
> innovation as a strategic sector for growth in Europe. That said, the report
> also noted that what is missing is a simple and strong execution plan behind
> it, with simplified regulation and coherent and predictable policies that
> could drive the European goals of increased competitiveness and strategic
> autonomy.
Europe’s marketing authorisation process now exceeds 14 months (444 days),
causing patients to wait nearly three months longer than in the US (356 days)
and over five months longer than in Japan (290 days) for access to innovative
medicines.[2] Such delays, combined with complex and lengthy country-level
market access systems, mean patients in Europe are waiting an average of 20
months longer than people living in the United States to benefit from scientific
innovation.[3]
Last year’s Draghi report on EU competitiveness importantly identified
pharmaceutical innovation as a strategic sector for growth in Europe. That said,
the report also noted that what is missing is a simple and strong execution plan
behind it, with simplified regulation and coherent and predictable policies that
could drive the European goals of increased competitiveness and strategic
autonomy.
Ongoing discussions on the revision of the General Pharmaceutical Legislation
and the In Vitro Diagnostic Regulation (IVDR), the Critical Medicines Act and
the upcoming Biotech Act (Part 1) mark crucial opportunities for Europe to
become a global leader for innovation. However, to make this vision a reality,
the EU must address structural challenges that undermine innovation and patient
access to novel, lifesaving medicines.
> To reverse the worrying decline in European clinical trial activity, the EU
> should implement a maximum two-month approval process for clinical trial
> applications (CTAs), encompassing the reviews of both regulators and ethics
> committees consistent with other global leaders.
The successful implementation of structural, future-proof policy changes can
ensure timely access to innovative medicines for EU citizens, and this can be
achieved through five key policy recommendations:
Facilitate and accelerate clinical trial applications
To reverse the worrying decline in European clinical trial activity, the EU
should implement a maximum two-month approval process for clinical trial
applications (CTAs), encompassing the reviews of both regulators and ethics
committees consistent with other global leaders. It is equally important to
increase collaboration among EU member states to remove unique and specific
national CTA requirements and questions, and to also introduce opportunities for
an informal dialogue with regulators to expediently address smaller challenges
that can be quickly fixed. Legislative overlaps and fragmentation between the
Clinical Trials Regulation (CTR) and the IVDR should also be addressed to avoid
delays in clinical trials that utilize companion diagnostics.
Expand expedited pathways
Despite their potential, the EU’s expedited pathways (such as the European
Medicines Agency’s PRIME scheme for unmet medical needs, Conditional Marketing
Authorisation and Accelerated Assessment) are underutilised, limiting rapid
patient access to important medicines. Similar expedited pathways are widely
used by other regulators around the world, like the United States and Japan.
Expanding the use of expedited pathways in the EU to new indications and
aligning eligibility criteria with global standards would ensure that the EU has
more competitive regulatory pathways and earlier patient access to life-saving
medicines.
Shorten scientific advice and approval timelines
Shortening the EU’s scientific advice procedure is critical to optimise the
development of innovative products, ensure timely and efficient resource
management for both applicants and regulators, and maintain the EU’s influence
in global scientific and clinical research. By evolving to a more integrated and
agile dialogue, the EU can provide comprehensive, consistent guidance throughout
the product lifecycle and remain competitive with other regions. Given their
growing number, scientific advice should be available for medicines used with
all types of medical devices and in vitro diagnostics (including combinations
diagnostics) to address the complexities of working across these regulatory
frameworks.
> An agile, modernized regulatory system — coupled with supportive intellectual
> property and access policies — can attract research and development and
> advanced manufacturing to Europe.
Regarding the current lengthy approval times, the proposed reduction of EMA’s
standard assessment timelines from 210 to 180 days — as suggested in the
revision of the pharmaceutical legislation — would allow regulators to
accelerate their scientific assessments. Furthermore, the European Commission
can streamline its decision phase (currently requiring up to 67 days) by
conducting its activities in parallel with the scientific assessment.
Strengthen the EU Medicines Regulatory Network and embrace regulatory sandboxes
Achieving greater speed and agility within a regulatory system requires an
appropriately resourced, sustainable regulatory infrastructure. We support
transparent regulatory budgets across the network, backed by consistent
investments in expertise, funding and infrastructure to support continuous
capacity and capability advancements. Collaborative regulatory pathways (such as
the EMA OPEN framework) could be further expanded to encourage simultaneous
approvals and supply chain resilience across geographies.
Additionally, regulatory sandboxes would be beneficial to pilot and adapt
frameworks for disruptive future innovations, while ensuring appropriate
guardrails to enable the safe development and implementation of these
innovations.
Enhance patient engagement
Effective regulatory decision-making requires both inclusivity and adaptability.
Limited patient and expert input can hinder effective regulatory
decision-making, while rapid pharmaceutical innovation requires adaptable
frameworks. Expert and patient perspectives are crucial for informed
benefit-risk and clinical meaningfulness determinations.
Disclaimer
POLITICAL ADVERTISEMENT
* The sponsor is Eli Lilly & Company
* The advertisement is linked to General Pharmaceutical Legislation (GPL), In
Vitro Diagnostic Regulation (IVDR), Critical Medicines Act (CMA), Biotech Act
(Part 1), Clinical Trials Regulation (CTR), EU Medicines Regulatory Network
More information here.
--------------------------------------------------------------------------------
[1] IQVIA, Assessing the clinical trial ecosystem in Europe, Final Report,
October 2024: efpia_ve_iqvia_assessing-the-clinical-trial-ct-ecosystem.pdf.
[2] Lara J, Kermad A, Bujar M, McAuslane N. 2025. R&D Briefing 101: New drug
approvals in six major authorities 2015-2024: Trends in an evolving regulatory
landscape. Centre for Innovation in Regulatory Science. London,
UK: https://cirsci.org/wp-content/uploads/dlm_uploads/2025/08/CIRS-RD-Briefing-101-v1.1.pdf.
[3] The Patients W.A.I.T. Indicator 2024 Survey.
https://www.efpia.eu/media/oeganukm/efpia-patients-wait-indicator-2024-final-110425.pdf
LONDON — Britain’s Department of Health is pressing ahead with plans to open up
a trove of pandemic-era patient data to outside researchers — despite concerns
from doctors’ representatives.
A formal direction titled “GP Data for Consented Research,” yet to be signed by
Health Secretary Wes Streeting but shared in draft format with doctors’ reps,
would enable NHS England to disseminate patient data originally collected solely
for the purpose of Covid-19-related research to other studies.
The Department of Health and Social Care (DHSC) confirmed to POLITICO that the
direction has been drafted and is awaiting Streeting’s signature.
A group of doctors has warned the government that the move could erode patient
trust. While the direction says government will obtain patient consent to share
the data more broadly, doctors groups are worried this won’t happen in practice,
and that patients won’t be aware their data is being funneled to other studies.
NHS England has been in discussions with the Joint GP IT Committee,
which comprises representatives from the British Medical Association (BMA) and
Royal College of General Practitioners (RCGP), about the data, a person close to
the talks told POLITICO.
DHSC confirmed it had been in dialogue with the doctors’ groups, and a
spokesperson said it had delayed signing the direction in order to engage with
doctors’ concerns.
The JGPITC argued it hasn’t been properly consulted on the change in line with
established governance processes, and that repurposing the dataset without
asking patients’ permission risks damaging already-fragile public confidence in
the profession, the same person said.
While the direction says government will obtain patient consent to share the
data more broadly, doctors groups are worried this won’t happen in practice, and
that patients won’t be aware their data is being funneled to other studies. |
Pool photo by Hannah McKay/EPA
It comes after the same group of doctors filed a formal complaint to the
Information Commissioner’s Office in June alleging that NHS England had breached
data protection law by training a general-purpose AI model on the same dataset
without consent. The disagreement is also set against the wider backdrop of a
long-running dispute between government and the BMA over doctors’ pay and
working conditions.
DHSC maintains that proper processes have been followed. “As the Secretary of
State made clear last year during his speech to the Royal College of GPs in
October 2024, we are committed to implementing this direction in line with
patients’ explicit consent for their data to be used in research,” a DHSC
spokesperson said.
‘CONSULTED EXTENSIVELY’
In his speech last month, Streeting said he would direct NHS England to take
responsibility for sharing patient data with projects including UK Biobank,
Genomics England and Our Future Health. “I know there are issues we need to work
through together around information governance, risk and liabilities,” he said.
“There’s also, let’s be honest, some producer interest in play.”
NHS England asked the JGPITC to confirm whether it was happy with the direction
on broadening access to the dataset by Nov. 4. The JGPITC couldn’t reach a
consensus to give its blessing to the change, the same person close to the talks
and cited above said.
The doctors’ group has pushed for NHS England to notify consenting participants
about where their data is going via text or the NHS App, they added. DHSC is
not obligated to comply with any of the JGPITC’s requests.
“We have consulted extensively with GP representatives over the past 18 months
to ensure patients’ wishes are respected and their data used appropriately,
while minimizing the burden on busy GPs,” DHSC’s spokesperson said.
As trilogue discussions on the Critical Medicines Act (CMA) approach, its
potential effects on medicine supply, patient access and Europe’s
competitiveness are increasingly in focus. From an industry standpoint, several
considerations are central to understanding how this act can best achieve
its objectives and support a robust pharmaceutical ecosystem in Europe.
Keeping the CMA focused where it matters
Much of the debate around the CMA has centered on its promises to strengthen the
availability and security of supply of critical medicines in the EU while
improving accessibility to other medicines. These are goals that our industry
fully supports.
The European Commission’s proposal is designed to focus on critical medicines,
with a vulnerability assessment foreseen to identify which products are truly at
risk of disruption and tailor solutions accordingly. Alongside critical
medicines, the proposal also introduces a new definition of ‘medicinal products
of common interest’. Under current wording, this would include any medicine
unavailable in at least three member states, regardless of
the underlying reason.
Such a broad definition risks turning a targeted framework for resilience into
an all-encompassing mechanism covering almost every medicine on the market,
blurring the distinction between supply and access challenges. These are
fundamentally different issues that require fundamentally different policy
tools.
> Applying the CMA’s tools across the entire medicines market would dilute
> priorities, stretch healthcare budgets and create administrative burdens for
> industry without delivering real benefits for patients.
The act will be far more effective if it remains focused on where the risks are
greatest — in other words, by limiting the ‘medicinal products of common
interest’ definition to cases of demonstrable market failure and directing
measures toward genuinely critical medicines with a proven risk of supply
disruption.
Fixing supply and access hurdles needs more than joint procurement
The CMA places joint procurement at the center of its strategy to address both
supply and access challenges. While this approach can contribute to improving
availability in certain circumstances, joint procurement will only deliver
lasting results if it is designed to address the underlying causes of access
delays and shortages, which vary across geographies and products.
For medicines where the main challenge lies in fragile supply chains, joint
procurement can play a role, particularly when it enhances predictability and
economic viability for suppliers. Experience from the Covid-19 pandemic has
shown that coordinated purchasing can be effective in targeted situations. For
medicines facing access delays, joint procurement could help improve
availability in countries where genuine market failures exist. However, the
value of joint procurement for countries where products are already available,
or where access barriers can be better addressed by improving national pricing
and reimbursement systems, is very questionable.
To ensure that joint procurement does not hinder access, several safeguards are
essential. Tenders should reward quality and promote innovation, recognizing the
value that innovative medicines bring to patients and society. Price
confidentiality must be protected to prevent unintended spillovers, such as
reference pricing effects. Once joint procurement agreements are concluded, to
ensure commercial and supply predictability there should be
no additional national renegotiations or expenditure control measures. Finally,
allowing national procurement processes to run in parallel will be key
to avoid delays and maintain flexibility.
Beyond these design safeguards, real progress will depend on tackling the
broader root causes of shortages and access delays. For supply fragility, this
means, among other actions, reducing strategic dependencies where necessary,
improving transparency across supply chains and avoiding rigid national
stockpiling rules. For access delays, progress will require addressing national
pricing and reimbursement challenges, and a greater willingness from governments
to reward the value that innovative medicines deliver.
Protectionism won’t make Europe stronger
Few elements of the CMA debate have attracted as much attention as the idea
of prioritizing EU-made medicines. The rationale is straightforward: producing
more within Europe is expected to reduce reliance on third countries, reinforce
strategic autonomy and, ultimately, improve supply security. While this
narrative is understandable, taking it at face value risks overlooking the
realities of how medicines are manufactured and supplied today.
Europe already has one of the world’s strongest pharmaceutical manufacturing
footprints and, unlike some other pharma manufacturing regions, Europe exports
71 percent of its pharmaceutical production. This output depends on global
supply networks for active substances,
raw materials and specialized technologies. Introducing local-content
requirements or preferential treatment for EU-made products would disrupt those
networks, fragment supply chains and drive up costs, with limited evidence that
such measures would enhance resilience. Local-content requirements could also
affect Europe’s trade relationships and weaken, rather than strengthen, its
industrial base in the long term, while distorting competition within the single
market and undermining the competitiveness of both European and international
companies operating in Europe. The likely outcome would be less diversity and
greater concentration in supply chains: the opposite of what a resilient system
requires.
If procurement criteria referencing resilience or strategic autonomy are used,
they should be proportionate and tied to clearly demonstrated dependencies or
supply risks. Protectionist approaches, however well-intentioned, cannot
substitute for the broader policy environment needed to keep Europe attractive
for investment in research and development and manufacturing. A competitive
European ecosystem depends first and foremost on predictable
intellectual-property rules, timely regulatory processes, access to capital, and
a strong scientific and technical skills base.
The EU institutions still have time to steer the CMA on course
The CMA offers a real chance to get things right. The European Parliament’s
proposal for more consistent contingency stock rules could help if it stays
focused on medicines genuinely at risk of shortage. The act can also make
reporting more efficient by using existing systems rather than creating new
ones. Policymakers should also be aware that wider regulatory initiatives
directly affect Europe’s ability to manufacture and supply medicines. A more
coherent policy framework will be essential to strengthen resilience.
Europe’s goal must be to build an environment where pharmaceutical innovation
and production can thrive. Europe’s choice is clear: supply security cannot be
achieved by weakening the industry that ensures it. The CMA will only work if it
tackles the right problems with the right tools and keeps competitiveness at its
core.
> Europe’s goal must be to build an environment where pharmaceutical innovation
> and production can thrive.
Our industry remains ready to engage with EU and national policymakers to make
that happen. A high-level forum on the CMA involving all stakeholders could help
guide the act’s implementation in a way that improves supply security and speeds
up access for patients, while reinforcing Europe’s position as a global player
in life sciences.
Disclaimer
POLITICAL ADVERTISEMENT
* The sponsor is European Federation of Pharmaceutical Industries and
Associations (EFPIA)
* The political advertisement is linked to the Critical Medicines Act
More information here.