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.

LONDON — The U.K. has imposed new sanctions on senior commanders of the Rapid Support Forces (RSF) amid escalating atrocities in Sudan. The move aims at key figures accused of mass killings, sexual violence and targeted attacks on civilians in El Fasher, including Abdul Rahim Hamdan Dagalo, the RSF’s deputy leader and brother of commander Mohamed “Hemedti” Dagalo. Three other senior RSF officers will also now face asset freezes and travel bans to the U.K. Foreign Secretary Yvette Cooper said the sanctions sent a message that atrocities “cannot and will not go unpunished.” While the U.K. has targeted other RSF figures before, the paramilitary group’s recent sharing of footage of their own alleged crimes has made it easier to establish the basis for sanctions. The penalties announced Friday coincide with a fresh £21 million aid package intended to provide food, clean water, healthcare and protection for tens of thousands caught in what the U.K. government has termed the world’s worst humanitarian crisis. The administration in London has been under pressure from lawmakers to do more to stop the bloodshed. The U.K.’s action follows the U.S. decision this week to sanction a network it says is recruiting former Colombian soldiers to fight in Sudan’s civil war, while the European Union has also targeted RSF leadership for alleged crimes in Darfur. Sudan has been locked in a civil war for two and a half years, with the Sudanese Armed Forces pitted against the Rapid Support Forces paramilitary group, which international institutions have accused the United Arab Emirates of backing. Since becoming foreign secretary, Cooper has sought to place particular emphasis on the conflict in Sudan and has discussed it with her U.S. counterpart Marco Rubio on several occasions. Donald Trump signaled a new interest in ending the violence in Sudan after meeting Saudi Crown Prince Mohammed Bin Salman in November, but it’s not yet clear if that will be sustained.

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.

Europe’s security does not depend solely on our physical borders and their defense. It rests on something far less visible, and far more sensitive: the digital networks that keep our societies, economies and democracies functioning every second of the day. > Without resilient networks, the daily workings of Europe would grind to a > halt, and so too would any attempt to build meaningful defense readiness. A recent study by Copenhagen Economics confirms that telecom operators have become the first line of defense in Europe’s security architecture. Their networks power essential services ranging from emergency communications and cross-border healthcare to energy systems, financial markets, transport and, increasingly, Europe’s defense capabilities. Without resilient networks, the daily workings of Europe would grind to a halt, and so too would any attempt to build meaningful defense readiness. This reality forces us to confront an uncomfortable truth: Europe cannot build credible defense capabilities on top of an economically strained, structurally fragmented telecom sector. Yet this is precisely the risk today. A threat landscape outpacing Europe’s defenses The challenges facing Europe are evolving faster than our political and regulatory systems can respond. In 2023 alone, ENISA recorded 188 major incidents, causing 1.7 billion lost user-hours, the equivalent of taking entire cities offline. While operators have strengthened their systems and outage times fell by more than half in 2024 compared with the previous year, despite a growing number of incidents, the direction of travel remains clear: cyberattacks are more sophisticated, supply chains more vulnerable and climate-related physical disruptions more frequent. Hybrid threats increasingly target civilian digital infrastructure as a way to weaken states. Telecom networks, once considered as technical utilities, have become a strategic asset essential to Europe’s stability. > Europe cannot deploy cross-border defense capabilities without resilient, > pan-European digital infrastructure. Nor can it guarantee NATO > interoperability with 27 national markets, divergent rules and dozens of > sub-scale operators unable to invest at continental scale. Our allies recognize this. NATO recently encouraged members to spend up to 1.5 percent of their GDP on protecting critical infrastructure. Secretary General Mark Rutte also urged investment in cyber defense, AI, and cloud technologies, highlighting the military benefits of cloud scalability and edge computing – all of which rely on high-quality, resilient networks. This is a clear political signal that telecom security is not merely an operational matter but a geopolitical priority. The link between telecoms and defense is deeper than many realize. As also explained in the recent Arel report, Much More than a Network, modern defense capabilities rely largely on civilian telecom networks. Strong fiber backbones, advanced 5G and future 6G systems, resilient cloud and edge computing, satellite connectivity, and data centers form the nervous system of military logistics, intelligence and surveillance. Europe cannot deploy cross-border defense capabilities without resilient, pan-European digital infrastructure. Nor can it guarantee NATO interoperability with 27 national markets, divergent rules and dozens of sub-scale operators unable to invest at continental scale. Fragmentation has become one of Europe’s greatest strategic vulnerabilities. The reform Europe needs: An investment boost for digital networks At the same time, Europe expects networks to become more resilient, more redundant, less dependent on foreign technology and more capable of supporting defense-grade applications. Security and resilience are not side tasks for telecom operators, they are baked into everything they do. From procurement and infrastructure design to daily operations, operators treat these efforts as core principles shaping how networks are built, run and protected. Therefore, as the Copenhagen Economics study shows, the level of protection Europe now requires will demand substantial additional capital. > It is unrealistic to expect world-class, defense-ready infrastructure to > emerge from a model that has become structurally unsustainable. This is the right ambition, but the economic model underpinning the sector does not match these expectations. Due to fragmentation and over-regulation, Europe’s telecom market invests less per capita than global peers, generates roughly half the return on capital of operators in the United States and faces rising costs linked to expanding security obligations. It is unrealistic to expect world-class, defense-ready infrastructure to emerge from a model that has become structurally unsustainable. A shift in policy priorities is therefore essential. Europe must place investment in security and resilience at the center of its political agenda. Policy must allow this reality to be reflected in merger assessments, reduce overlapping security rules and provide public support where the public interest exceeds commercial considerations. This is not state aid; it is strategic social responsibility. Completing the single market for telecommunications is central to this agenda. A fragmented market cannot produce the secure, interoperable, large-scale solutions required for modern defense. The Digital Networks Act must simplify and harmonize rules across the EU, supported by a streamlined governance that distinguishes between domestic matters and cross-border strategic issues. Spectrum policy must also move beyond national silos, allowing Europe to avoid conflicts with NATO over key bands and enabling coherent next-generation deployments. Telecom policy nowadays is also defense policy. When we measure investment gaps in digital network deployment, we still tend to measure simple access to 5G and fiber. However, we should start considering that — if security, resilience and defense-readiness are to be taken into account — the investment gap is much higher that the €200 billion already estimated by the European Commission. Europe’s strategic choice The momentum for stronger European defense is real — but momentum fades if it is not seized. If Europe fails to modernize and secure its telecom infrastructure now, it risks entering the next decade with a weakened industrial base, chronic underinvestment, dependence on non-EU technologies and networks unable to support advanced defense applications. In that scenario, Europe’s democratic resilience would erode in parallel with its economic competitiveness, leaving the continent more exposed to geopolitical pressure and technological dependency. > If Europe fails to modernize and secure its telecom infrastructure now, it > risks entering the next decade with a weakened industrial base, chronic > underinvestment, dependence on non-EU technologies and networks unable to > support advanced defense applications. Europe still has time to change course and put telecoms at the center of its agenda — not as a technical afterthought, but as a core pillar of its defense strategy. The time for incremental steps has passed. Europe must choose to build the network foundations of its security now or accept that its strategic ambitions will remain permanently out of reach. -------------------------------------------------------------------------------- Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Connect Europe AISBL * The ultimate controlling entity is Connect Europe AISBL * The political advertisement is linked to advocacy on EU digital, telecom and industrial policy, including initiatives such as the Digital Networks Act, Digital Omnibus, and connectivity, cybersecurity, and defence frameworks aimed at strengthening Europe’s digital competitiveness. More information here.

PARIS — Foreign pensioners who dream of spending their retirement under the sun in the French Riviera might have to reconsider their plans if their free health care gets axed. France wants non-European Union pensioners who are currently benefitting from the public health care system to start paying for it. It’s a move that would particularly affect American retirees, who have flocked to one of Europe’s most generous welfare states not only for its food, scenery and culture, but also, in some cases, for its world-class free health care. “It is a matter of fairness,” François Gernigon, the lawmaker who put forward the proposal, told POLITICO. “If you are a French citizen and you move to the U.S., you don’t have reciprocity, you don’t benefit from free social security.” Under French law, non-working citizens from outside the EU who have a long-stay visa and can prove they have sufficient pension or capital revenue (more than €23,000 annually) as well as private health care insurance can, after three months, obtain a carte vitale, which gives them free access to public health care. At that point, they can annul their previous private health insurance and benefit from the French one. It’s become a popular choice for U.S. retirees in recent years. But a majority of French lawmakers wants to put an end to that situation and make them pay a minimum contribution. France wants non-European Union pensioners who are currently benefitting from the public health care system to start paying for it. | Stephane de Sakutin/AFP via Getty Images That idea already passed in two branches of the parliament this month during budgetary discussions, and could see the light as soon as next year as the government has also backed it. Gernigon said that even U.S. expats have told him they don’t find the current situation normal and that they are ready to contribute more. Under the latest version of the proposal, as modified by the French Senate, only non-EU citizens who are not paying taxes or contributing to other welfare programs in France would be required to pay the new minimum contribution. Lawmakers have not fixed the contribution amount as it will be up to the government to do it later. For Gernigon, the value could vary depending on the level of health care coverage, but it would still be cheaper than private insurance in the U.S. or abroad which, he said, costs around €300 to €500 per month. The debate comes as France struggles to cut spending and bring down its budget deficit to 5 percent of gross domestic product next year. Gernigon said he had not yet evaluated how much revenue these new contributions would raise, but acknowledged that his main goal is fairness rather than fixing France’s budget problems. “This is not what is going to fill the hole in the social security budget,” he 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.

COPD affects over 390 million people, including more than 36 million in Europe, and is poised to be the leading cause of hospital admissions over the next decade worldwide.1,2,3 In Europe, countries such as Ireland, Romania and Denmark have among the highest hospital admission rates for people with COPD, representing significant costs for health systems.4 Meanwhile, countries like Norway and Germany spend the most per patient on COPD management.5 Awareness is rising, and more stakeholders are taking a proactive approach to address the growing burden of COPD. However, it remains an underestimated and under-resourced disease. Innovation in COPD offers significant opportunities for more proactive patient care, where exacerbations and hospitalizations could be prevented. By investing in the latest wave of healthcare innovation and prioritizing preventative methods, the growing economic and patient burden of COPD can be mitigated. Understanding the patient burden To truly understand COPD, it’s critical to recognize its impact on patients. For most, COPD means a daily struggle with breathlessness, persistent coughing and increased fatigue as their lung function gradually deteriorates. These symptoms can severely limit their ability to do everyday tasks such as walking the dog, climbing stairs or even carrying groceries, impacting their quality of life and overall well-being.6 This, in turn, can lead to considerable financial burden for people affected by this condition due to limitations on workplace and home productivity, and the costs of medical treatment, impacting the EU’s competitiveness.6 And the picture gets worse when patients experience exacerbations. The patient cost of COPD exacerbations, and resulting hospitalizations, is equally profound. Tragically, one in ten patients hospitalized for COPD will die during their stay.7 About one in four will not live to see another year,8 and half will succumb to the disease within five years.9  But even before these dire outcomes, the impact of COPD is felt in the diminished quality of life, frequent sick leave and increasing disability that patients endure between exacerbations, creating dependencies within families and adding to the emotional and financial strain. > Tragically, one in ten patients hospitalized for COPD will die during their > stay.7 About one in four will not live to see another year,8 and half will > succumb to the disease within five years.9 For individuals who recover, each exacerbation inflicts irreversible damage, significantly degrading lung function, increasing disability and severely impacting quality of life. This leads to a greater reliance on healthcare services over time, creating a vicious cycle of health decline. The disease also takes an immense emotional toll on families and caregivers, who stand witness to their loved one’s devastating disease progression and often bear the care burden. In the Netherlands, caregivers of COPD patients with exacerbations provide up to 14 hours of informal care weekly.10 In Spain, it’s estimated that over 220,000 caregivers are needed to support those with COPD-related disabilities.11 > Since my diagnosis with COPD, the biggest challenge for my wife and I is the > uncertainty. I wake up every morning wondering if this will be a good day or a > bad day. Will I be able to go about my usual activities or face a debilitating > exacerbation? Durham, person living with COPD Currently, resources are often concentrated on managing advanced disease, missing the crucial opportunity for earlier and more effective intervention through disease-specific programs and early detection. Prioritizing prevention is essential to improving outcomes for patients and alleviating pressure on already strained health systems. A proactive shift toward prevention and sustained disease management is urgently needed. Hospitalizations and the growing financial burden on health systems Global COPD expenditures are projected to reach €3.7 trillion by 2050, with 45-70% of these costs linked to managing exacerbations. Comparatively, EU governments spent €1.25 trillion on healthcare overall in 2023, implying an increasing cost burden related to COPD in the coming years.12,13,14 Remarkably, approximately 70 percent of the total costs associated with treating COPD stem directly from hospital stays.15 Collaborative efforts such as the Joint Action on Chronic Respiratory Diseases (JARED) and the MEP Lung Health Group are crucial for driving policy changes and improving COPD management across the EU. > Policymakers increasingly see COPD as a driver of hospital admissions: 41 > percent now rank it among the top three causes of hospital admissions in their > country behind only heart disease and stroke — a sharp rise from 8 percent in > 2022.16 Although this awareness is rising, so are the costs. In Europe, the estimated annual medical cost of COPD ranges from €1,963 to over €10,701 per person among adults aged 45 years and older, depending on disease severity. COPD-related hospitalizations are 2-3 times more expensive than other disease-related hospitalizations.17,18,19 This is primarily driven by longer stays, higher rates of intensive care unit use, a greater need for post-discharge support, and increased risk of readmissions, reflecting the complex and resource-intensive nature of managing exacerbations. Current COPD management focuses on symptom control, often overlooking the critical need to reduce exacerbations and hospitalizations. Prioritizing early intervention and prevention: A call to action While the challenges posed by COPD are significant, there is an opportunity to take decisive action. By implementing concerted, consistent and coordinated efforts to tackle COPD in a systemic way, we can mitigate its impact and improve patient outcomes. We can lead in this area, setting a standard for proactive COPD management and demonstrating the value of investing in early intervention and prevention.   To address the multifaceted patient and health system costs of COPD, a shift toward proactive strategies is essential. There are already promising initiatives of such strategies being implemented across Europe, such as national lung health programs that emphasize early diagnosis in primary care settings and integrated vaccination programs for at-risk adults, demonstrating that progress is within reach through collaboration and shared learning. Complementing these systemic efforts, patient engagement is a crucial component in effective COPD management. When patients are engaged and actively involved in their care, they are better equipped to recognize worsening symptoms and seek timely help. Tools like the COPD Exacerbation Recognition Tool play a vital role by increasing patient awareness of early signs and empowering them to respond quickly, potentially reducing the severity of flare-ups and avoiding costly hospitalizations.20 Shifting the system from reactive crisis care toward proactive, preventative approaches and early intervention is what ultimately may keep more people out of hospital. A lot of progress has been made on prioritizing the ongoing burden of COPD, but there is more to do. It’s time that we rethink our approach to care and ask ourselves, what more can we do to truly support patients and national healthcare systems? At GSK, we believe in working across the healthcare ecosystem and with governments to learn from one another, support new innovation, and build a system that prioritizes early intervention and prevention of unnecessary exacerbations and hospitalizations. It is our collective responsibility to act now. This should be seen not just as a medical imperative, but as a strategic investment in healthy populations and economic stability. November 2025 NP-GBL-CPU-WCNT-250002 -------------------------------------------------------------------------------- 1. Boers E, Barrett M, Su JG, et al. Global Burden of Chronic Obstructive Pulmonary Disease Through 2050. JAMA Netw Open. 2023 Dec 1;6(12):e2346598. doi: 10.1001/jamanetworkopen.2023.46598. 2. Benjafield A, Tellez D, Barrett M, et al. An estimate of the European prevalence of COPD in 2050. European Respiratory Journal 2021;58(suppl 65):OA2866; doi: DOI: 10.1183/13993003.congress-2021.OA2866. 3. Khakban, Amir et al. “The Projected Epidemic of Chronic Obstructive Pulmonary Disease Hospitalizations over the Next 15 Years. A Population-based Perspective.” American journal of respiratory and critical care medicine vol. 195,3 (2017): 287-291. doi:10.1164/rccm.201606-1162PP. Accessed April 2025. 4. Organisation for Economic Co-operation and Development. (2022). Health at a glance: Europe 2022. OECD Publishing. https://doi.org/10.1787/507433b0-en 5. Rehman, M., et al. (2021). Cost analysis of chronic obstructive pulmonary disease (COPD): a systematic review. Health Economics Review, 11 : 31. https://doi.org/10.1186/s13561-021-00329-9. 6.WHO. Fact Sheet: Chronic obstructive pulmonary disease (COPD). Accessible at: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) [last accessed October 2025] 7. Sin DD. Should COPD stand for “comorbidity-related obstructive pulmonary disease”? Eur Respir J. 2015;46(4):901-2. doi: 10.1183/13993003.01112-2015 8. Serra-Picamal X, Roman R, Escarrabill J, et al. Hospitalizations due to exacerbations of COPD: A big data perspective. Respir Med. 2018;145:219-225. doi: 10.1016/j.rmed.2018.01.008 9. Suissa S, Dell’Aniello S, Ernst P. Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. Thorax. 2012;67(11):957–963. doi: 10.1136/thoraxjnl-2011-201518.  10. Melles, M.C., et al. “The cost impact of informal care for patients with COPD and exacerbations in the Netherlands.” American Journal of Respiratory and Critical Care Medicine, vol. 211, no. Abstracts, May 2025, https://doi.org/10.1164/ajrccm.2025.211.abstracts.a3256. 11. PMC, Europe. Europe PMC, europepmc.org/article/PMC/4334315. Accessed 31 Oct. 2025. 12. Chen S, Kuhn M, Prettner K, et al. The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020-50: a health-augmented macroeconomic modelling study. Lancet Glob Health. 2023;11(8):e1183-e1193. doi: 10.1016/S2214-109X(23)00217-6 13. Koff PB, Min SJ, Freitag TJ, et al. 2021. Impact of Proactive Integrated Care on Chronic Obstructive Pulmonary Disease. Chronic Obstr Pulm Dis 8(1): 100-16 14. Government Expenditure on Health – Statistics Explained – Eurostat, ec.europa.eu/eurostat/statistics-explained/index.php?title=Government_expenditure_on_health. Accessed 31 Oct. 2025. 15. Hunter LC, Lee RJ, Butcher I, et al. Patient characteristics associated with risk of first hospital admission and readmission for acute exacerbation of chronic obstructive pulmonary disease (COPD) following primary care COPD diagnosis: a cohort study using linked electronic patient records. BMJ Open. (2016) 6:e009121. 16. Ipsos (2025) Data on file: Global Policymakers’ Perspectives on COPD | Survey of Attitudes and Perceptions – Wave 2 Final Report (conducted on behalf of Global Allergy and Airways Patient Platform). 17. Rehman AU, Hassali MAA, Muhammad SA, et al. The economic burden of chronic obstructive pulmonary disease (COPD) in Europe: results from a systematic review of the literature. Eur J Health Econ. 2020;21:181–94. 18. Agarwal D. COPD generates substantial cost for health systems. Lancet Glob Health. 2023;11:e1138-9. 19. Løkke A, Lange P, Lykkegaard J, et al. Economic Burden of COPD by Disease Severity – A Nationwide Cohort Study in Denmark. Int J Chron Obstruct Pulmon Dis. 2021;16:603-613. doi: 10.2147/COPD.S295388 20. Jones PW et al. (2022). The Development of a COPD Exacerbation Recognition Tool (CERT) to Help Patients Recognize When to Seek Medical Advice. International Journal of Chronic Obstructive Pulmonary Disease, 17, 213‑222. DOI: 10.2147/COPD.S337644. --------------------------------------------------------------------------------

AMSTERDAM — Everyone’s talking about migration. Apart from Europe’s center left. The Party of European Socialists (PES), Europe’s second-biggest political family, is holding a three-day get-together in Amsterdam starting Thursday to fire up the troops as they push back against a right-wing surge. But for all the fanfare, they won’t be spending much time talking about one of the hot-button issues fueling that populist rise. How to handle migrant flows into Europe has divided the center left, with some, such as the Nordics, opting to harden their stance and back tough deportation rules, while others, especially the Spanish, continue to defend taking a softer approach. As a result, the PES congress will tiptoe around the issue. “Migrants are increasingly criminalized and used as a scapegoat for social and economic hardships and to justify discriminatory policies,” reads the sole reference to the topic in the final declaration of the congress, obtained by POLITICO and set to be voted on Friday. A Social Policy program, to be approved the same day, mentions the need to ensure “the protection of migrants, asylum seekers and undocumented people.” Migration is not mentioned in a document setting out the party’s priorities and campaign talking points for the years to come, also obtained by POLITICO, and there are no scheduled debates on the topic. Even those relatively minor mentions of the protection of undocumented migrants raise questions about the unity of the party, as the Danish Socialists have prioritized establishing a tough deportation scheme during their EU Council presidency, which began in July and runs to the end of December. Danish Prime Minister Mette Frederiksen will not be at the PES jamboree. Instead of addressing migration, the Socialists are turning to their traditional core subjects — health care, job creation, affordable housing and renewable energy — as the core of their campaign program, according to their priorities for the years to come, to be voted on by party delegates on Friday. TAKING ON TRUMP During the past five years, the center left has seen its support slump across European countries and its number of EU lawmakers fall, with a right-wing bloc in command of the European Parliament and most members of the College of Commissioners hailing from the center right. The PES congress — which brings together left-wing political movements, NGOs, unions and activists — is meant to set the principles socialists across Europe will defend in taking on “Reactionary International.” (The term was popularized by Spanish Prime Minister Pedro Sánchez and other leaders to describe the transatlantic populist right-wing movement led by U.S. President Donald Trump.) “Only by standing united can we have the critical mass needed to reverse the dangerous course charted by Trump and his allies,” reads a congress declaration, yet to be adopted but pre-approved by PES leadership. “We call for the launch of a Global Progressive Mobilization.” Yet only one of the three socialist prime ministers in the EU — Sánchez — will be showing up. Apart from Denmark’s Frederiksen, Malta’s Robert Abela is also not on the list of attendees. Migrants from various detention centers across Italy are escorted by police as they disembark an Italian Navy Offshore Patrol Vessel. | Adnan Beci/AFP via Getty Images “All our leaders are invited and may join at the last moment,” PES spokesperson Catarina Faria told POLITICO. She added that Frederiksen is not attending “due to elections in Denmark” — even though the next scheduled elections in the country are local ballots on Nov. 18. Frederiksen and Abela’s offices did not reply to requests for comment. “I don’t think there is any reason for concern … It’s natural sometimes for leaders to have different kinds of agendas, but I think what is essential for us to achieve is this mobilization of our political family and that’s why we our leaders will be, of course, very much involved in the years to come,” said PES Vice President and Romanian MEP Victor Negrescu. Sánchez, who is facing mounting challenges to his leadership in Madrid, will headline the congress, joined by European Council President António Costa, German Vice-Chancellor Lars Klingbeil, Austria’s Vice-Chancellor Andreas Babler and national party leaders.  HOPING TO MAKE GAINS Negrescu said the center left is hoping to do well in upcoming elections. “The most important one is the one in the Netherlands,” he said of the vote scheduled for Oct. 24 in which the Labour Party is on course to enter government. Party leader Frans Timmermans (a former Commission Green Deal chief) could even end up as prime minister if his party finishes ahead of the Christian Democrats. Negrescu also noted that center-left parties in Sweden and Finland are leading in the polls (those countries elect new governments in 2026 and 2027, respectively). Despite a bruising past few years at the ballot box, the PES is sticking with the old guard as its leadership. PES President Stefan Löfven — a former Swedish prime minister who runs the party from Stockholm while also working for consultancy Rud Pedersen — is running to be re-elected unopposed. Secretary-General Giacomo Filibeck will also stay on, and Löfven has proposed keeping the center left’s top two members of the European Parliament — Iratxe García and Katarina Barley — in place as vice-presidents. Sarah Wheaton contributed reporting.

The Italian government has approved a draft budget that would aim to collect as much as €4.5 billion from Italian banks and insurers to help finance a modest package of tax cuts and support measures for health care and salaries. In a statement late Tuesday, Italian Finance Minister Giancarlo Giorgetti estimated the package, worth an estimated €18 billion, “intervenes in a context of significant uncertainty.” He added it would support “households’ purchasing power, businesses and social needs, while also ensuring the sustainability of public finances.” Prime Minister Giorgia Meloni’s focus on slashing Italy’s deficit to escape an EU special monitoring regime has left the government with a slimmed-down budget with scarce headroom for flashy policies, prompting continued calls from the hard-right flank of her ruling coalition for “contributions” from financial institutions. While ongoing discussions between the government and banks have yet to yield an agreement on what form the tax would take, the hard-right League, of which Giorgetti is a member, is seeking between €4 billion and €4.5 billion from a range of measures, according to two people familiar with the matter. The measures would also apply to insurers, one of the people said. Earlier this week, the government proposed reviving a failed 40 percent tax on “windfall” profits from 2023 at a reduced rate, as POLITICO reported. The banks have already agreed to the temporary suspension of tax incentives, extending a measure implemented last year. Major policies included in the draft budget, which Italian lawmakers will study in the coming months, include a €9 billion cut to income taxes for the Italian middle class to 33 percent from 35 percent and €2 billion to align salaries with the cost of living after years of stagnation. The draft, which is due to be sent to the European Commission on Wednesday, also earmarks €3.5 billion for “anti-poverty measures” and €2.4 billion for health care in 2026.

BRUSSELS — The EU says it has a new problem when it comes to artificial intelligence: Companies are not using it. As Europe struggles to counter America’s overwhelming dominance in the artificial intelligence space, a strategy out Wednesday and seen by POLITICO will target faster adoption of the technology as a way to turn things around. European companies have been slow to deploy AI to change the way they’re working. Less than 14 percent of European businesses used AI in their activities last year, well behind the global trend. Lucilla Sioli, the boss of the European Commission’s AI Office, admitted at a POLITICO event this month that’s “not a great number.” The solution? “Targeted measures to boost AI use in key sectors of the economy,” according to the draft of Wednesday’s strategy. It outlines ways to integrate the technology into 11 industries, ranging from manufacturing and defense to health care and mobility — with proposals including supporting AI models for autonomous driving and drug discovery, as well as an app store for farmers. As places such as the U.S., the Middle East and China put the technology front and center, Europe’s slow embrace risks squandering the bloc’s best chance to restore its waning economic growth — even as the EU has failed to develop its own models. While Wednesday’s strategy is not about winning the race for homegrown artificial intelligence models, it acknowledges that efforts to build the underlying technology so far have been unsuccessful. Europe’s “dependencies” on other regions for AI hardware could be weaponized and pose a significant supply chain risk, the draft says. Yet companies shouldn’t hold back from using the technology, according to the executive. “Whenever a company or public office faces a new challenge, the first question must be: How can AI help?” Commission President Ursula von der Leyen told an event in Turin on Friday ahead of the release. GETTING DOWN TO BUSINESS While 4 out of 10 large companies in Europe used some sort of AI technology last year — including text mining, generation and creating images — that figure stood at 1 in 10 for smaller companies. Although data is patchy, that’s a big difference from estimates elsewhere. The U.S. Chamber of Commerce estimates that almost 60 percent of small businesses in America use AI. A survey by McKinsey reckons the use globally could be as high as 78 percent. Investing in AI is more affordable for companies that can roll out technology at scale. But companies also have to figure out where to invest, which is seen as a major hurdle. “More than 600,000 Polish companies want to invest in cloud and AI in the next six to eight months,” Polish Digital Minister Dariusz Standerski said in an interview in September. | Martin Bertrand/Hans Lucas/AFP via Getty Images The Polish government surveyed companies on their willingness to invest in cloud and AI. “More than 600,000 Polish companies want to invest in cloud and AI in the next six to eight months,” Polish Digital Minister Dariusz Standerski said in an interview in September. He argued that money is not always the problem, and neither is the burden of changing processes to roll out technology. The problem is instead that companies “only see …. universal solutions,” and not a “specific solution suited for [their] company,” Standerski said. For many, AI is primarily still associated with mass-market chatbots, such as OpenAI’s ChatGPT. That leaves many specialized companies wondering what it can do for them. The draft strategy aims to address this, with the EU set to support a range of improvements for various industries and use cases, and roll them out at scale. Most are small steps. For example, the EU plans to support a farmer-focused app store to allow farmers to browse and discover AI-powered apps, according to the draft. For robotics and manufacturing, it plans so-called “acceleration pipelines” to speed up AI-powered robotics and manufacturing solutions. For the creative industries, it would support studios specializing in AI-enhanced production and develop a platform to utilize AI translation, making foreign-language news more widely accessible. Some of the initiatives are more ambitious in their plans to address dependence on foreign-owned AI, for example, such as a plan to ramp up support for European artificial intelligence models for real-time understanding of the battlefield. Top Commission officials have raised the bar for themselves ahead of the release, arguing the goal of the strategy is to plug AI into companies’ core activities — not just for support services. “What we want to see is that companies integrate AI in their production process,” said Sioli of the Commission’s AI Office. “It’s not about having ChatGPT on your desk when you go to work, and then you tick a box that you use AI.” “We are looking at the core processes, because the supporting processes, that’s relatively easy, already many companies have taken it up,” Małgorzata Nikowska, the AI Office’s head of unit for innovation and policy coordination, said at a hackathon organized by OpenAI and startup lobby group Allied for Startups in mid-September. The real test of success, she said, will be whether Europe can persuade companies to redesign their production processes to use AI.