NAVLIN Daily NewsCheckout Today’s News
The Trump administration published its final prices for the 15 prescription drugs selected for the second round of negotiation under the Inflation Reduction Act (IRA), with discounts ranging from 38-85% compared to current list pricesCompared to current list prices, Janumet, Breo Ellipta, and Tradjenta face the steepest discounts; meanwhile, Austedo landed the lowest discount of the groupNotably, the negotiated prices for semaglutide (Wegovy, Ozempic, and Rybelsus), are more than the recently announced “MFN” price achieved in the White House's one-off deal with Novo Nordisk. The Trump administration has yet to address the discrepancy
The French Senate has adopted some amendments while withdrawing others from Article 34 of the draft 2026 Social Security Financing Bill (PLFSS), which reforms France’s early access (accès précoce) and direct access (accès direct) schemes for innovative medicinesAlthough senators supported renewing the direct access experiment for two additional years, they rejected several key components of the reform. Senate discussions highlighted concerns that the proposed overhaul of early access risked restricting patient access to innovative therapies, especially for those with rare or serious illnessesAccording to the Senate’s explanatory notes, the reform could “delay access to care” and cause “a real loss of therapeutic opportunity”
The Observer has reported that the UK government is in advanced discussions with the White House on a deal that could see the National Health Service (NHS) pay substantially more for U.S.-made medicines under a raised QALY thresholdThe deal would include a commitment from the UK to raise the cost-effectiveness thresholds used by the National Institute for Health and Care Excellence (NICE). Specifically, it would increase the maximum cost per QALY from today’s £20,000–£30,000 to £25,000–£35,000 or above, as previously rumoredThe report specifies that this would be calculated in real terms, protecting additional drug revenues from being offset by higher taxation (the Voluntary Scheme for Branded Medicines Pricing, Access, and Growth (VPAG)), and would only apply to future drug launches
Last week saw a wide range in HTA decisions in Europe, with France’s High Authority for Health (HAS) declining Eisai and Biogen’s Leqembi (lecanemab) for early Alzheimer’s, giving it an “Insufficient” SMR rating and no ASMR improvement. NICE ended its review of AstraZeneca’s Enhertu (trastuzumab deruxtecan) for HER2-low breast cancer, however, in Germany, G-BA gave Eli Lilly’s Retsevmo (selpercatinib) a "significant" added benefit, which reflects the highest possible rating and a major, previously unachieved therapeutic improvementIn wider Europe, EU pharma reform talks hit a deadlock, the UK’s VPAG deadline was extended again until December 2025, and France dropped an amendment on price transparency from its PLFSS for 2026Meanwhile, NAVLIN Daily attended Advanced Therapies USA 2025, where experts discussed U.S. payer trends for cell and gene therapies, and experts advocated for a more flexible FDA review process. Read on to find out more
Welcome to NAVLIN Daily’s new global weekly policy roundup, where we will hand-select the most important changes in market access around the world and deliver them straight to your inbox every FridayThis is a complimentary preview of our new service. If you would like to continue receiving these updates, please contact connect@navlin.com for a subscriptionThis newsletter provides highlights region by region: United States, Europe, Asia & South Pacific, Middle East, Sub-Saharan Africa and Latin America. At the bottom, we also provide our “On the Horizon” scan to help you stay on top of key expected upcoming events, including policy updates and implementation milestones on reforms. Please reach out if you have any suggestions or comments regarding this new service, as your feedback is important to us
A parliamentary Committee has warned that the UK’s life sciences sector is losing faith in the government’s ability to deliver stable and credible policies on medicine pricing and uptake, urging the Health Secretary to take “urgent” corrective actionOn September 17, a meeting convened after a string of announcements from AstraZeneca, GSK and MSD signalling that the UK’s life sciences environment has become “challenging” and “unfriendly.” At that session, industry representatives pointed to voluntary scheme for branded medicines pricing, access and growth's (VPAG) 23.5% payment rates, outdated NICE cost-effectiveness thresholds, and barriers to NHS uptake as key factors driving decisions to withdraw investmentAs a result, in a letter sent to Health Secretary Wes Streeting, Dame Chi Onwurah, Chair of the Science, Innovation and Technology Committee, emphasized: "To many, it looks like the UK lacks sovereignty over key NHS pricing decisions, and I urge the Health Secretary to make clear how he will ensure [U.S.] trade negotiations don’t take precedence over domestic policy priorities”
Andrew York, Executive Director of Maryland’s Prescription Drug Affordability Board, discussed U.S. payer trends for cell and gene therapies at Advanced Therapies USA 2025. Despite fears of runaway costs, payers have integrated these treatments more steadily than expected. Key concerns remain high upfront costs and uncertainty about long-term benefits, as well as how to spread costs fairly across payers as patients move between plansThe federal CGT Access Model, focusing on Sickle Cell Disease, has expanded to 33 states and uses outcomes-based deals with manufacturers—an approach York sees as promising. However, many federal pricing initiatives like the 340B Rebate Model or tariffs on pharmaceuticals don't directly affect cell and gene therapies. Medicaid, commercial payers, and self-insured employers are using methods like stop-loss insurance and amortization to handle the risks of these pricey treatmentsPayer innovation on reimbursement models lags due to inertia and limited claims data. Strategies like outcomes-based agreements sound great but are tough to implement. Advice to pharma: support payers in overcoming barriers
Ramesh Arjunji, VP at Nanoscope Therapeutics, outlined a roadmap for generating real-world evidence (RWE) to secure gene therapy reimbursement at Advanced Therapies USA 2025. Key steps include defining the value proposition, evaluating patient journeys, addressing evidence gaps, stakeholder alignment, and streamlining value communication. Arjunji emphasized tailoring RWE to show durability and differentiation of therapies like gene treatments for conditions like Hemophilia ATo maximize value, Arjunji urged focusing on the evidence needed to reflect cost savings, extended quality of life, and population-specific benchmarks. He stressed leveraging diverse data sources like health records and wearable tech, while collaborating with stakeholders, policy makers, and advocacy groups. Evidence gaps should be prioritized by impact and feasibility, with adaptive planning to address payer concerns and highlight curative advances effectivelyArjunji shared strategies to break down access barriers, urging partnerships with patient advocacy groups for newborn screenings and unmet-need validation. He recommended a proactive value communication approach using tools like Core Value Dossiers, field training, and pre-approval payer dialogues. Citing ICER’s past reviews, he advised companies to prepare for payer assessments and emphasized patient-centered transparency for better access to therapies like vision loss treatments
Members of the Pharmaceutical Research and Manufacturers of America (PhRMA), including Pfizer CEO Albert Bourla, met with Japanese officials on Nov 18 to address Japan's drug pricing policies. They highlighted concerns over low initial drug prices, frequent price cuts, and the impact of the U.S.'s Most Favored Nation (MFN) pricing policy on Japan's pharmaceutical sectorAt the meeting, PhRMA called for reform of Japan’s system to ensure it does not continue to decline in competitiveness. Specifically, PhRMA urged the Japanese government to maintain drug prices during patent periods, limit price cuts, improve initial pricing for new drugs, and develop a national pharma innovation strategy for global competitivenessCompanies have already seen impacts on products in Japan due to MFN. All 10 companies recently surveyed by the Japanese arm of the European Federation of Pharmaceutical Industries and Associations (EFPIA) responded that they believe MFN will impact their global pricing strategy
Elizabeth White from Orphan Therapeutics Accelerator discussed alternative approaches to fund, develop, and commercialize gene therapies for rare diseases at Advanced Therapies USA 2025. The non-profit biotech firm focuses on treatments without profitable pathways and leverages a network of specialized service providers, Orphan ClinDevNet, to lower costs and streamline progressTackling ultra-rare drug challenges, White highlighted issues like high costs, low patient numbers, inaccessible genetic testing, and shrinking government funding. She also noted a shift in intellectual property back to academic centers and the large number of abandoned drug programs, leaving gaps that Orphan Therapeutics aims to fill by advancing and commercializing these neglected assetsThe organization is building a comprehensive database that uses AI to rank rare disease gene therapy assets. This tool will help connect investors with suitable opportunities. Orphan Therapeutics also works on creative commercialization strategies, including spin-offs, direct-from-academia deals, and partnerships, to bring overlooked therapies to market efficiently
650+
+99%
<24
4,000+
24x7
99.5%
