Your biweekly update on health economics, policy, and impact
This Bulletin looks at why Germany's drug-pricing standoff could make or break MFN, why patients across Europe are waiting longer for new medicines, and whether HTA should widen its lens beyond healthcare costs.
Within the UK, restricted availability typically takes the form of a NICE optimised decision. Our latest paper finds that in 2023 and 2024, half of NICE's positive appraisals fell into this category, approved for a narrower population than the licence permits. Reasons underpinning these decisions go beyond cost-effectiveness and include NHS clinical practice and earlier NICE guidance. Over three-quarters of these optimised recommendations left more than half of eligible patients without access.
The consequences extend beyond Britain, as the UK features in the Most Favoured Nation (MFN) policy. While the UK-US Arrangement on Pharmaceutical Pricing has been signed, focus now shifts to Germany. Our insight sets out why.
What Germany's cost-cutting means for MFN
Germany’s drug-pricing dilemma: Why Europe’s pivotal market holds the key to the MFN debate
Germany is the EU's largest economy, a pharmaceutical powerhouse, and a major exporter with a huge trade surplus with the US. Whereas the UK has leaned into higher prices and spending to protect its life sciences sector, Germany is moving the opposite way, and tightening pharmaceutical costs to plug a growing statutory health insurance deficit. This makes it central to the MFN debate.
The 2025 EFPIA Patients W.A.I.T. Indicator survey shows patients across Europe are waiting longer for new medicines, with huge gaps between countries — from 93% availability in Germany to just 5% in Turkey, North Macedonia, and Bosnia and Herzegovina. Average access times have grown from 509 to 607 days since 2019. As MFN pricing and the new Joint Clinical Assessment reshape how medicines reach patients, this insight looks at what these indicators do and don't capture.
The case for a broader, societal perspective in health technology assessment has been building for years, but so have the arguments against it. Grace Hampson and Chris Skedgel discuss whether HTA should look beyond patient health and healthcare costs.
Informal carers are vital to patient outcomes, yet capturing their quality of life in HTA remains a challenge. Join the OHE masterclass at 13:00 BST on 17th September 2026 – it is for anyone working at the intersection of HTA, economic modelling, and patient/carer-centred evidence.
OHE Annual Lecture 2026 Paying for prevention: the global health financing challenge
Health systems worldwide spend billions treating diseases that could have been prevented. Join Dr Eduardo Banzon, Director of the Health Practice at the Asian Development Bank, at 18:00 BST on 6th October 2026 at The King's Fund to discuss why we continue to underinvest in prevention and what's needed to change it.
