Pharmaceuticals: China and the US are racing ahead: ‘We now need a strategy to defend ourselves’

“We do not want to be anyone’s slaves, but we now need a clear direction, a strategy to defend the pharmaceutical sector, which is one of the driving forces behind our economy.” Marcello Cattani, fresh from his re-election as president of Farmindustria, is standing on stage at the public meeting in Rome, with figures projected behind him that encapsulate the meaning of his words: the US accounts for over a third (35 per cent) of global research into new medicines, flanked by China (32 per cent), which in turn has achieved a historic overtaking for the first time, having discovered more new drugs (46) in 2025 than the United States (28) and the EU (16) combined. “We find ourselves in an international geopolitical context offering many opportunities, but also many risks, and an alliance is needed between all stakeholders in the system to maintain investment, manage rising costs and address health risks,” emphasises the president of Farmindustria. Yesterday, he highlighted the record figures for the Italian pharmaceutical sector, with production worth 74 billion (a European record) and exports of 69 billion – up 248 per cent over the last 10 years – contributing one-third (33 per cent) towards the government’s target of 700 billion in exports by 2027. These records could now be jeopardised by the new ‘geopolitics’ of the pharmaceutical sector, which risks sidelining Europe, a continent that ‘is asleep at the wheel and not making a move’. The Old Continent is, in fact, caught between a rock and a hard place, squeezed by the US and China: on the one hand, Trump’s aggressive policy, which – thanks in part to the Most Favoured Nation (‘MFN’) clause on price alignment with other countries (including Italia) – is increasingly pushing Big Pharma to invest overseas: ‘At least 400 billion over the next five years, on top of the 100 billion already invested’. On the other hand, China has become a colossus thanks to substantial incentives, ‘set to overtake Europe and the United States combined in the discovery of new drugs for the first time in 2025’.

This is why it is more urgent than ever for the Government to defend the pharmaceutical sector – Prime Minister Meloni described it yesterday in a statement as ‘a strategic sector and a flagship of “Made in Italy”’ – with Farmindustria identifying four priorities that must be addressed urgently to meet the challenge of competitiveness: from abolishing the ‘payback’ scheme – ‘a tax on taxes’ that stifles investment and costs businesses 2.4 billion – to managing US policy on drug pricing under the ‘MFN’ clause, from the proposed revision of the formulary – with price cuts deemed ‘unworkable for companies’ – to reducing the time it takes for patients to access treatments, with Italian patients currently having to wait hundreds of days after approval by the EMA, the EU’s medicines agency, before new treatments become available.

In short, the pharmaceutical sector is sounding a loud wake-up call for Italy and Europe because – as Antonio Gozzi, Confindustria’s delegate for European strategic autonomy, said yesterday, Mattei Plan and Competitiveness – ‘the pharmaceutical industry is concrete proof that the Italian manufacturing sector can compete at the highest international levels and, figures in hand, refutes the doomsayers and the constant whingeing about the supposed decline of Italian industry’. This achievement was acknowledged by the various ministers who took to the stage yesterday at the Farmindustria Assembly: from Foreign Minister Antonio Tajani, who pledged his commitment to reducing the ‘bureaucratic burden’ and ‘payback’ on companies, to Business Minister Adolfo Urso, who spoke of ‘a new “Made in Italy” model that is making its mark on the world and driving exports’, and the Minister for Universities and Research, Anna Maria Bernini, who is pushing for ‘industrial PhDs and new roles to bring research into companies’. Closing the session was Health Minister Orazio Schillaci, who, on the possibility of revising the pharmaceutical formulary – the list of medicines covered by the National Health Service – gave assurances that he did not want “citizens to pay more for medicines or be denied access to them”. Health Undersecretary Marcello Gemmato is also playing for time: ‘The Budget Law stipulates that the new pharmaceutical formulary is to come into force on 1 January 2027, so we have plenty of time to carry out thorough investigations’. However, he makes it clear that there will be no radical changes, partly because expenditure is growing at a slower rate than in the past: “Over the five-year period 2014–2019, there was an average increase of 7 per cent in pharmaceutical expenditure. Between 2019 and 2024, the increase was 7.2 per cent, and in 2025 it was 5.7 per cent, which is more than 20 per cent lower.” This point was firmly reiterated by Farmindustria’s president, Mr Cattani, himself: “Pharmaceutical expenditure is not out of control; it is growing at a natural rate in line with the population’s changing needs and with pharmaceutical innovation, which is contributing to increased life expectancy.”