Life Sciences and Health Care Partners Author Global Drug Pricing and Market Access Chapter in Pharmaceutical Pricing & Reimbursement 2026

Ropes & Gray partners Lincoln Tsang, Eve Brunts and Katherine Wang co-authored the book chapter entitled “Global Drug Pricing and Market Access: The New Era of Cost Containment, Innovation, and Patient Access,” in Global Legal Insights Pharmaceutical Pricing & Reimbursement 2026.  

The global pharmaceutical industry stands at a pivotal crossroads, challenged to deliver cutting-edge therapies while ensuring affordability and broad patient access. Rapid innovation—especially in oncology, rare diseases, and chronic conditions—has transformed treatment landscapes, but the financial sustainability of health systems is under intense strain. The COVID-19 pandemic and ongoing geopolitical disruptions have exposed vulnerabilities in medicine supply chains, prompting governments and payors to prioritize supply security, diversify sourcing, and reinforce procurement frameworks. Escalating healthcare costs, aging populations, and the high prices of novel medicines are pushing policymakers to deploy a diverse arsenal of cost-containment strategies. These include direct price negotiations, international reference pricing, value-based reimbursement, and mandates for greater transparency.

Pharmaceutical companies now operate in a volatile environment where launch strategies, pricing models, and investment decisions face constant scrutiny. Risks of launch delays, product withdrawals, and market fragmentation are rising—especially in smaller or lower-priced markets. Traditional procurement models focused on lowest price are being reimagined. Today, broader value criteria—such as patient-reported outcomes and real-world effectiveness—are central to pricing and reimbursement decisions. Regulatory frameworks increasingly emphasize “most economically advantageous tender” (MEAT) criteria, balancing cost with qualitative benefits like supply resilience and patient experience.

In the United States, cost containment has become a policy centerpiece. The Most Favored Nation (MFN) pricing model and international reference pricing programs (e.g., GENEROUS, GLOBE, GUARD) benchmark US drug prices against those in other developed nations. The Inflation Reduction Act (IRA) empowers the federal government to negotiate prices for high-cost Medicare medicines, delivering substantial discounts and lowering patient out-of-pocket expenses. These reforms are reshaping global launch sequencing, as manufacturers reconsider launches in lower-priced countries to avoid price convergence. Legal challenges to US policies have failed, and new regulations targeting pharmacy benefit managers are increasing transparency and reducing patient costs. Direct-to-consumer discount models are also gaining traction, empowering patients to access affordable medicines.

Europe faces its own complexities. Fragmented pricing and reimbursement systems are under pressure from US reference pricing, leading to increased launch delays and product withdrawals. The UK has responded with a bilateral trade deal with the US, raising its cost-effectiveness threshold and capping rebate rates, though concerns persist about NHS spending and the robustness of cost-effectiveness assessments. The EU is advancing major legislative reforms—the Pharma Package, Critical Medicines Act (CMA), and EU Biotech Act—to boost competitiveness, strengthen supply chains, and incentivize local research and production. The new EU Health Technology Assessment Regulation (HTAR) introduces a Joint Clinical Assessment process, raising evidence standards and harmonizing requirements across Member States. Despite these efforts, challenges such as flat pharmaceutical spending, low venture capital investment, and threats to confidential discount mechanisms remain.

China is forging its own path, expanding access to innovative medicines through the National Healthcare Security Administration (NHSA) and the National Reimbursement Drug List (NRDL). The introduction of a new Category C for highly innovative drugs, covered by commercial insurance, reflects China’s dual focus on affordability and innovation. Price negotiations and volume-based procurement continue to drive down costs but concerns about supply sustainability and investment in innovation persist.

Across all regions, the drive for pricing transparency, value-based care, and resilient supply chains is intensifying. Policymakers, payors, and industry leaders must navigate a complex web of trade-offs to ensure affordable access, reward innovation, and sustain healthcare systems. The future of global drug pricing and market access hinges on the ability of governments and industry to collaborate, adapt, and innovate in an interconnected, cost-conscious world.