Healthcare policy shifts reshape pricing, M&A

Drug makers agree to Most Favoured Nation pricing amid U.S. tariff pressure

In 2025 December nine global drugmakers entered into Most Favoured Nation (MFN) pricing agreements with the United States, aligning the cost of certain prescription drugs with pricing in other developed countries. Historically, U.S. drug prices have been two to three times higher for brand-name medications.

The participating companies are Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Genentech, Gilead Sciences, GSK, Merck, Novartis and Sanofi. New drugs launched in the United States by these companies will be priced at MFN rates in commercial and cash-pay markets, as well as for Medicare and Medicaid.

MFN agreements are a form of benchmarking, where each company independently agrees with the government to price new drugs at or below a specified international price. Industry experts believe that ongoing Section 232 tariff investigations focused on the pharmaceutical industry are influencing these MFN deals. Section 232 refers to U.S. authority to impose tariffs on products tied to national security. The threat of punitive tariffs on exports to the United States is widely seen as a key motivator.

This comes at the same time when several global pharmaceutical companies have announced large manufacturing investments in the United States. It may take several years to determine the agreements’ long-term impact on drug affordability, patient access and domestic manufacturing.

FDA loosens rules for medical device review

In mid-December, the U.S. Food and Drug Administration (FDA) removed limitations on the use of real-world evidence in drug and medical device applications. The inability to consider evidence collected during routine medical practice rather than clinical trials has long been a barrier to getting life-changing treatments to patients faster.

Historically, the FDA required real-world evidence to include private, confidential information at the patient level. This made most large databases with valuable macro-level data ineligible for product applications. Now, this additional data will be accepted, expediting approval.

The FDA also plans to update the guidance for biologics.

2026 may bring more healthcare mergers and acquisitions

Recent U.S. policy changes such as cuts to Medicaid are expected to increase the number of uninsured Americans in 2026, which could put more financial pressure on healthcare providers. According to a recent PwC study, these changes are prompting healthcare companies to reach for competitive advantages, often through mergers and acquisitions.

Healthcare mergers and acquisitions paused somewhat in 2025 due to regulatory changes and uncertainty. A turnaround is expected in 2026. Healthcare companies that are successfully using artificial intelligence as a tool to manage telehealth platforms, clinical documentation and administrative tasks are among the most attractive targets for investors.

2026 is also expected to bring a continuation of the trend towards more healthcare IPOs. After the IPO market in the sector came to a virtual standstill in 2022-23, last year brought a noted uptick in the number of companies to go public. Most activity was concentrated in medtech and healthcare services, as investors prioritised durability.

The largest company to go public in 2025 was medical supplies maker Medline, bringing in $6.2 billion. This year, investors may begin to shift their focus to mature biotech companies, but they are expected to remain conservative and risk-averse.

In this environment, supply chain efficiency will be an increasingly important way for healthcare companies to control operating costs. To stay competitive, healthcare shippers must use data to drive decisions and partner closely with logistics providers to turn insights into action and build supply chains that are flexible and resilient.

Latest tariff updates

USMCA review update

The six-year review of the U.S.-Mexico-Canada Agreement (USMCA), which will reshape trade relations between its members, is under way. While the administration hasn’t committed to its renewal, it has made it clear that it favours nearshoring within North America. A decision is expected by July 2026.

Supreme Court tariff decision

A ruling on whether the administration can levy tariffs under the International Emergency Economic Powers Act (IEEPA) is now expected this month, possibly as early as Friday, 9 January, when the Court issues its first round of rulings for the new year. If overturned, importers may receive refunds, though expectations for a quick refund process are low.

For more details, go to the Trade Policy & Customs section of this report.

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