In this episode of the Vital Health Podcast, host Duane Schulthess speaks with Harry Bowen, Economic Research Partner at Vital Transformation, about Most-Favored-Nation (MFN) drug pricing and the lessons they draw from Europe's experience with price controls. They discuss how pricing rules, revenue uncertainty, and regulatory choices influence market access and the geography of pharmaceutical innovation.

Key Topics:

• MFN Pricing Incentives: International reference pricing, launch decisions, links between U.S. and European markets.
• European Approval Trade-offs: Centralized review, national decision-making, consistency and time to market.
• Investment and Uncertainty: Expected returns, late-stage financing, retrospective clawbacks and revenue planning.
• Global Innovation Competition: Mobile research investment, changing capabilities, Europe's experience and China's role.
• Policy and Evidence: Historical comparisons, incentives and unintended effects, distinguishing policy explanations from broader economic change.

Resources Discussed:

• The historical impact of price controls on the biopharma industry (Schulthess & Bowen, 2021): https://vitaltransformation.com/2021/11/the-historical-impact-of-price-controls-on-the-biopharma-industry/
• Pharmaceutical regulation in Europe and its impact on corporate R&D (Eger & Mahlich, 2014): https://link.springer.com/article/10.1186/s13561-014-0023-5
• The EU General Pharmaceutical Legislation & Clawbacks: Calculated impacts - both designed and unintended (Schulthess et al., 2024): https://vitaltransformation.com/2024/03/the-eu-general-pharmaceutical-legislation-clawbacks-calculated-impacts-both-designed-and-unintended/
• Savings from Most-Favored-Nation Drug Pricing Policy (White House, 2026): https://www.whitehouse.gov/research/2026/05/savings-from-most-favored-nation-drug-pricing-policy/
• The Inflation Reduction Act’s Impact Upon Late-Stage R&D (Bowen et al., 2026): https://vitaltransformation.com/2026/05/preprint-new-research-the-inflation-reduction-acts-impact-upon-late-stage-rd/
• EIRA 2026 conference information: https://eirainitiative.org/events/

Opinions expressed are those of the speakers. Discussion recorded on 9/19/26.

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