Could Switzerland Be Next? U.S. Drug Pricing Pressure Expands Beyond Germany

The United States is examining German pharmaceutical pricing practices under a trade investigation that could have consequences well beyond Germany. Switzerland, France, and other countries may face similar scrutiny.

For pharmaceutical companies, this is becoming a question of where to launch new medicines, how to negotiate prices, and whether decisions made in Europe could affect revenue in the United States.

I recently discussed these developments with Francesca Bruce at Pink Sheet, including which countries could face additional scrutiny and how governments might respond.

Why Switzerland Could Be Next

The U.S. Trade Representative opened a Section 301 investigation into German pharmaceutical pricing practices in June. The investigation includes Germany's AMNOG benefit assessments, mandatory rebates, and drug price freeze.

The concern is that these policies may place an unfair burden on American commerce.

Switzerland is another country worth watching.

In June, members of Congress raised concerns about Swiss proposals to reduce pharmaceutical spending. René Buholzer, CEO of the Swiss pharmaceutical industry association Interpharma, also warned that Switzerland could face scrutiny similar to Germany's.

Switzerland faces an additional complication. Unlike Germany and France, it is not an EU member and would need to manage any U.S. trade dispute through its own negotiations.

That does not leave Switzerland without options. It does mean the Swiss government and pharmaceutical industry may need to respond independently.

France Has Taken a Different Approach

France recently reached an agreement between its pharmaceutical pricing authority, CEPS, and the industry association Leem.

The agreement seeks to make pharmaceutical pricing more predictable, better recognize innovative medicines, and allow temporary higher prices in certain circumstances.

Those changes may help France respond to American concerns about European drug pricing.

They do not necessarily settle the matter.

The United States could still examine France's broader pricing framework, including pharmaceutical taxes, rebates, reimbursement delays, and patient access. Proposed increases in pharmaceutical taxes for 2027 could complicate France's efforts.

Could Germany Reach a Deal With Washington?

Germany may ultimately choose to negotiate rather than risk additional tariffs on pharmaceutical exports to the United States.

The UK-U.S. pharmaceutical trade agreement offers one possible model. Under that agreement, the UK committed to increasing pharmaceutical spending over time and improving market conditions for manufacturers.

Germany could consider a similar arrangement, particularly if the government concludes that a negotiated solution offers greater certainty for its pharmaceutical industry.

That outcome is far from guaranteed. Germany would still need to balance domestic healthcare spending against pressure from Washington.

What Pharmaceutical Companies Should Watch

Companies developing international launch and pricing strategies should pay attention to three questions.

First, will additional countries become targets of U.S. trade investigations?

Second, will European governments change pharmaceutical pricing or reimbursement policies to reduce the likelihood of trade disputes?

Third, how might those changes affect the timing of product launches, licensing agreements, and expected U.S. revenue?

The answers will matter to established pharmaceutical manufacturers and smaller biotechnology companies preparing for commercialization.

Pricing decisions made in one country no longer have consequences confined to that market. Companies must consider how those decisions could affect their business elsewhere.

The German investigation is still developing. Switzerland and France have not been established as the subjects of equivalent new investigations. For now, manufacturers should distinguish policy proposals and political warnings from formal government action.

Related reporting: Ron Lanton discussed these issues with Francesca Bruce in her October 21, 2026 Pink Sheet article, “USTR Investigation Into German Drug Pricing: Who Could Be Next?”.

Ron Lanton is Senior Partner and Global Strategist at Lanton, Lanton & Sosa Law PLLC, advising healthcare and life sciences organizations on regulatory, pharmaceutical policy, and international business matters.

This article is provided for general information and is not legal advice.

U.S. Most-Favored-Nation Drug Pricing Raises Questions Beyond the Price of Medicines

The renewed focus on most-favored-nation drug pricing in the United States is often discussed as a straightforward question of whether the government can bring American drug prices closer to those paid in other countries. The consequences could be much broader.

I recently spoke with Jen Brogan of APM Market Access about several of those issues, including how pharmaceutical manufacturers may approach future drug launches, what happens when pricing decisions in one country begin affecting another market, and whether countries outside the United States could face additional pressure as the policy develops.

One of the biggest questions is launch sequencing. Pharmaceutical companies do not make launch decisions one country at a time without considering what happens elsewhere. If a lower price negotiated in one market can eventually influence the price available in the United States, companies may have to reconsider where and when certain products are introduced. The answer may also differ considerably depending on the drug, its patient population, available alternatives and the economics surrounding the product.

APM Market Access examined that issue in “U.S. MFN could shift pharma launch sequencing ‘per class of drug’ – legal expert”.

The policy may also affect products already on the market differently from new medicines. Existing products already have established pricing, reimbursement arrangements and commercial expectations across multiple countries. That can make changing the economics surrounding those products particularly complicated.

APM addressed that question in “MFN could put greater short-term pressure on existing drugs than new launches – pricing expert”.

There is also a legal issue that deserves attention. International reference pricing can create situations where pricing information or arrangements in one market begin influencing decisions in another. That does not automatically create an antitrust problem. It does mean companies need to pay close attention to how pricing information is obtained, communicated and used when commercial decisions are being made across markets.

That issue was discussed in “U.S. MFN policy raises potential ‘antitrust’ questions over cross-market drug pricing, says legal expert”.

Finally, this is not only a U.S. policy discussion. Countries with significant pharmaceutical industries and comparatively lower medicine prices may find themselves part of the debate.

Switzerland is a particularly interesting example. It is home to some of the world's largest pharmaceutical companies, while the country is also dealing with its own questions about pharmaceutical competitiveness, research investment and the economics of maintaining a strong life sciences sector. If the United States places greater importance on international price comparisons, Switzerland and other European markets could face difficult choices between controlling domestic healthcare spending and maintaining an environment that attracts pharmaceutical investment.

APM explored that issue in “Switzerland could become target of U.S. pressure on drug pricing, says legal expert”.

Taken together, these questions illustrate why MFN cannot be evaluated solely by looking at the price of a prescription today. Drug pricing policy can affect launch decisions, investment, competition, reimbursement and the relationship between pharmaceutical markets around the world.

For pharmaceutical manufacturers, healthcare organizations, policymakers and investors, the important question will be how those consequences develop as the policy moves from announcement to implementation.

APM Market Access Coverage

U.S. MFN could shift pharma launch sequencing ‘per class of drug’ – legal expert
APM Market Access

MFN could put greater short-term pressure on existing drugs than new launches – pricing expert
APM Market Access

U.S. MFN policy raises potential ‘antitrust’ questions over cross-market drug pricing, says legal expert
APM Market Access

Switzerland could become target of U.S. pressure on drug pricing, says legal expert
APM Market Access

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