This week’s top stories capture the growing tensions between affordability, innovation, and access across multiple borders.
Trump Expands MFN Pricing as Pharma Faces Pressure at Home and Abroad
The Trump administration announced drug-pricing agreements with major drugmakers such as Sanofi, Novartis, and Merck, claiming the deals will lead to lower drug prices in the U.S. Companies agreed to sell at reduced prices to Medicaid and via a new federal website, TrumpRx.gov, alongside commitments to price future launches competitively.
Additionally, Amgen, Boehringer Ingelheim, and Gilead Sciences have reached agreements with the Trump administration to lower certain drug prices as a part of a strategy involving Most Favoured Nation (MFN) pricing. GSK has also agreed to partner with the U.S. government to support domestic accessibility for respiratory treatments, while avoiding tariffs for three years.
Bristol Myers Squibb has committed to providing Eliquis for free to the Medicaid program and donating significant active pharmaceutical ingredients to reinforce U.S. supply chains. U.S. President Donald Trump also announced plans to engage health insurers in discussions to curb rising premiums, particularly as insurance subsidies face expiration.
Meanwhile, Trump recently claimed during a rally in North Carolina that he pressured French President Emmanuel Macron to increase drug prices by threatening tariffs, aiming to lower costs for Americans. However, the French government swiftly dismissed Trump’s account, pointing out that the French president does not have the power to set drug prices.
The Centers for Medicare & Medicaid Services (CMS) proposed two mandatory payment models that are part of U.S. President Donald Trump’s Most Favoured Nation (MFN) initiative, designed to reduce Medicare drug costs by aligning them with prices in other countries. Recently, the Trump administration announced agreements with nine pharmaceutical companies to offer drugs at discounted rates under the MFN.
As part of the administration’s drug pricing plan, TrumpRx.gov is set to launch in January 2026. The site aims to bypass traditional pricing systems by negotiating directly with drug companies and foreign governments, potentially offering savings of up to 600%.
Despite federal requirements for drug price transparency, the Trump administration proposed a rule that will allow pharmaceutical companies and pharmacy benefit managers to keep prescription drug prices concealed. The decision delays transparency efforts mandated over five years ago, keeping net drug prices, which include rebates and real insurance costs, out of public view, maintaining their influence over the pharmaceutical industry’s economic structure.
A recent analysis highlighted that drug launch prices have been rising faster than inflation, with net launch prices for 154 medicines increasing by 51% from 2022 to 2024. The report argued that price increases should be benchmarked against value rather than inflation, noting that groundbreaking drugs offer new capabilities.
Global market consultant Neil Grubert discussed the potential impacts of the MFN pricing on drug prices and availability in Switzerland and other countries. Roche CEO Thomas Schinecker believes countries like Switzerland might see higher drug prices relative to GDP, while countries like Italy may enjoy lower prices compared to the U.S.
France’s 2026 security finance bill to increase tax and price pressures on pharma
According to Citeline, the French National Assembly has adopted a version of the 2026 social security finance bill that introduces price cuts for pharmaceuticals and additional taxes targeting companies that delay generic entry, signalling a stricter regulatory and fiscal environment for the pharma sector. This measure is expected to increase the financial burden on pharmaceutical companies operating in France.
Canada’s Health System Struggles with Bed Shortages, Workforce Strain, and Reform Gaps
A recent report from Le Journal de Montréal indicates that about one in six hospital beds in Quebec is occupied by patients who no longer require acute care, contributing to system bottlenecks and straining emergency departments as respiratory viruses surge over the holiday period, pointing to broader challenges in care transitions and capacity planning, prompting provincial health authorities to pursue targeted measures to address inappropriate occupancy.
In a Healthy Debate commentary, experts outline a “medicine wish list” for Canada’s health system that calls for investing in generalist clinicians and resisting the assumption that more care always equals better care, arguing that strengthening longitudinal, first-contact care and aligning system design with workforce realities could improve continuity, access, and diagnostic accuracy.
A Healthy Debate analysis frames system reform around the need for safe staffing and structural support, warning that without fully funded public care and safe workplaces, patient outcomes and provider retention will suffer. The commentary pushes for elevating health system design that supports high-quality care for all residents and embedding staffing safety as a policy priority.
A separate Healthy Debate article characterizes Canada’s primary care system as “fractured” and no longer fit for purpose, noting that access gaps persist despite high physician numbers on paper.
Health Canada Approves First-Ever Drug for Postpartum Depression
In a significant breakthrough, Health Canada has approved Zurzuvae, the first drug specifically designed to treat postpartum depression, is seen as a notable advancement in women’s mental healthcare. Known generically as Zuranolone, the medication offers a 14-day oral treatment that begins to alleviate symptoms as quickly as day three, a significant improvement over traditional antidepressants, which can take longer to show effects and may have mixed efficacy.
Despite its clinical significance, experts like Dave Patriarche, president of Mainstay Insurance Brokerage Inc., suggested that the impact of Zurzuvae on employer-sponsored drug plans will likely be minimal. The medication is classified as a high-cost drug, with its price in Canada projected between $15,000 and $20,000, like its U.S. cost of approximately $16,000 USD.
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