The chairs of nine of Europe's largest pharmaceutical companies — AstraZeneca, GSK, Novo Nordisk, Sanofi, Roche, Novartis, Boehringer Ingelheim, Chiesi, and Ipsen — wrote to Andy Burnham and other European national leaders on Tuesday warning that the continent is "losing ground" to the US and China. Over $600bn in pharmaceutical investment has been announced in those two countries in the last two years alone, the letter states, and European governments must act to attract next-generation medicines investment "before it's too late." The numbers are stark and largely corroborated by EFPIA data. Europe's share of global pharmaceutical R&D spending has fallen from 43% in 1990 to 31%. Its share of commercial clinical trials has halved in a decade, from 18% to 9%. Only 4% of European clinical trials focus on cell and gene therapies. China has overtaken Europe in clinical trials, pharma patents, and new drug development, its trial share surging from under 10% to nearly 30% in the same period. The patient-access picture is equally bleak. Nearly half — 49% — of newly approved therapies did not reach European patients last year, up from 46% in 2019. Drugs that do arrive take an average of nearly 600 days. The disparity within Europe is enormous: a median 56 days in Germany versus 1,201 days in Romania. The EFPIA attributes this to slow regulatory processes and insufficient national health budgets. The letter frames medicines as "strategic infrastructure" on par with defence and energy, arguing the sector supports millions of skilled jobs and generates an EU trade surplus exceeding €220bn. Closing the clinical trials gap alone, the signatories claim, could generate €53bn and create 82,000 jobs. The companies ask governments to create conditions that attract investment in next-generation medicines and secure "health sovereignty." What the letter does not dwell on is the other side of the ledger. The UK's public row last year over drug pricing — resolved in December when ministers agreed to spend billions more on NHS medicines after pressure from Donald Trump — illustrates the tension at the core of this appeal. The companies want faster regulatory approvals, larger public health budgets allocated to their products, and investment-friendly conditions. These are legitimate asks, but they are also asks for public money to flow toward private shareholders. The framing of "health sovereignty" borrows the urgency of defence spending to justify what is substantially a request for more favorable procurement and pricing terms. Europe's regulatory caution and price discipline are among the reasons drugs cost less here than in the US. If European governments respond by loosening pricing controls and accelerating approvals without demanding reciprocal commitments on access and affordability, the outcome could be higher public spending with marginal improvement in patient outcomes — the US model, in other words. The structural problem is real: Europe is losing its edge in pharmaceutical innovation, and the geopolitical implications of depending on US and Chinese drug pipelines are serious. But the solution proposed — essentially, make Europe more attractive to the same nine companies writing the letter — conflates the public interest in health sovereignty with the corporate interest in favorable investment conditions. Whether those interests align depends entirely on the terms governments negotiate.
