A survey of 175 executives from 67 pharmaceutical companies describes global drug-pricing and market-access policy changes as an “earthquake” that could reshape commercialization for years. The main pressures include U.S. Medicare price negotiation under the Inflation Reduction Act, emerging Most-Favored-Nation-style pricing, and pricing and reimbursement reforms in Europe and Japan. Because countries increasingly use international reference pricing, launch price and launch timing in one market can affect negotiations and revenue in others. Executives are reconsidering the traditional launch sequence—U.S. first, followed by Europe and other markets—and may delay, sequence differently, or abandon launches of expensive specialty medicines in lower-price countries. Companies are placing greater emphasis on clinical and economic value evidence, market access planning, indication sequencing, outcomes-based agreements, and real-world evidence. The article warns that selective non-l...
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