US Pricing Reform Reshapes Drug Launch Strategies: Dee Chaudhary

As the rules of global pharmaceutical launches are rewritten, patients may be the ones getting left behind, said Dee Chaudhary, principal of commercial strategy consulting in life sciences and healthcare at Clarivate.

During an interview at Asembia’s AXS26, Chaudhary delivered a stark assessment of how sweeping US drug pricing reforms are forcing manufacturers to rethink where, when, and whether they bring high-cost specialty drugs to market. She also shared her perspective during the session "Swallowed by Reform: IRA, OBBB, MFN Pricing, and the Future of High-Cost Specialty Drugs.”

At the center of her analysis was the Most Favored Nation (MFN) pricing policy, which aims to anchor US drug prices to the lowest prices paid by peer nations. Chaudhary explained that this creates a fundamental strategic problem: if a manufacturer launches abroad at a lower price, that price can effectively set a ceiling on what they can charge in the US, which is historically the world's most profitable market. The result is a measurable pullback from international markets.

“You're seeing people choose not to launch in France,” she noted, adding that similar hesitation is emerging in Germany and Nordic countries, where officials have already voiced concern that products will simply bypass their markets entirely.

For smaller companies that rely on international partnerships and licensing alliances, the stakes are even higher. Chaudhary emphasized that ex-US partners must align with pricing guardrails that protect American profitability, or the entire business model unravels.

With these increasing pressures, it’s possible that products that don’t have any real benefit will fall by the wayside, but there are concerns that manufacturers might find it commercially unviable to bring certain products to the market.

“The people in the end that lose in this are the patients and their families," Chaudhary said plainly. “You can always say, too, that some of the products that don't have any real benefit will just fall by the wayside. The real concern is, what about those products that have a big impact on the lives?”