AIPM is calling for urgent policy action as global pharmaceutical pricing tensions, United States pressure and Europe’s own cost-control measures reshape the economics of bringing innovative medicines to smaller markets. The organization says Hungary is caught in a “double squeeze” that could make early launches of new therapies increasingly unattractive for drug developers.
“Immediate and radical intervention is needed because of the global pharmaceutical market shockwaves caused by U.S. pricing policy and the double pressure experienced in Hungary,” AIPM said in its assessment. “Hungary has walked into a systemic trap, and the only way out is the immediate introduction of a three-pillar strategic framework.”
The warning comes at a time when access to innovative medicines is becoming one of the central competitiveness questions in European healthcare policy. According to AIPM, the old balance of the global pharmaceutical market has broken down. The United States now generates around 60% of global pharmaceutical revenues, while Europe’s share has shrunk to roughly 20%, even as China’s research and development capacity and market presence are expanding rapidly.
This imbalance has fed into Washington’s “Most Favored Nation” pricing approach, which aims to reduce what U.S. policymakers describe as “global free-riding” on American pharmaceutical spending. AIPM argues that the United States, through programs and mechanisms such as TrumpRx (a U.S. government-operated prescription drug website to help Americans find lower prices on prescription medications through government-negotiated discounts and direct purchasing options), pressure on pharmacy benefit managers, and Section 301 trade investigations, is seeking international price parity and a more favorable domestic pricing environment.
“The message is clear: the United States will no longer finance global innovation alone,” AIPM said. “It expects smaller markets to take a proportionate share of research and development costs.”
For Hungary, AIPM says the risk is especially acute because the country is exposed to both U.S. and European pressures. If low prices in Europe are used as benchmarks in the United States, manufacturers become less willing to launch new medicines early in lower-priced markets. A low introductory price is no longer simply commercially unattractive, AIPM argues, but may become a global strategic risk for companies.
At the same time, Europe’s larger markets are tightening their own cost-control systems. Germany and others have moved to strengthen mandatory discounts and expenditure limits, triggering a broader pricing chain reaction across the continent. Hungary, however, had already operated with a comparatively strict cost-control environment before these recent changes.
There is a third element to the problem: Hungary’s external reference pricing system. Through its pricing basket, AIPM says Hungary effectively “imports” Western European price cuts, while domestic legal rigidity and an unpredictable business environment make the country increasingly unattractive for early access launches.
AIPM’s language is unusually blunt. It describes Hungary as having become “a legally toxic market” for the early introduction of innovative medicines. The consequences, it says, are already visible. In the 10 months following the introduction of the new U.S. approach, the number of new product launches in the examined European countries fell by 43%, while product withdrawals rose by 40%.
The organization argues that the issue is not merely an industry concern. If companies delay or avoid launching products in Hungary, the direct effect is felt by patients who wait longer for treatments that are already available elsewhere. In some cases, the therapies may never reach the market at all under normal reimbursement conditions.
The funding gap is also significant. AIPM says innovative pharmaceutical spending as a share of GDP stood at 0.78% in the United States in 2023, compared with a European median of 0.31%. Hungary has no single precise figure, but estimates put the country at 0.11% according to the European Federation of Pharmaceutical Industries and Associations’ calculations and 0.25% according to the Pharmaceutical Research and Manufacturers of America’s estimates.
According to AIPM, this underfinancing is already contributing to structural erosion. Global pharmaceutical companies have started scaling back or restructuring local subsidiaries, while Hungary is losing what the organization calls its “sectoral ambassadors.” It also argues that parts of the Hungarian market remain frozen in outdated pricing logic, with some pricing agreements still reflecting levels set around two decades ago.
AIPM is proposing a three-pillar framework built around predictability, financing and transparency. The first pillar would restore what it calls the “market rhythm” by introducing strict 180-day deadlines for reimbursement decisions and requiring the publication of reimbursement lists at least once a year.
The second pillar concerns funding. AIPM says the “silent erosion” and chronic underplanning of the pharmaceutical budget must be stopped. It calls for structural inflation correction in long-standing price agreements and a meaningful increase in the budget allocated to innovative medicines.
The third pillar is transparency. The organization says Hungary needs a full simplification of reimbursement categories and clearer public spending statistics to reduce bureaucratic friction and make the system more understandable for all participants, from decision-makers and healthcare providers to patients and manufacturers.
“We cannot isolate ourselves from the transformation of the global pharmaceutical order, but we can change whether Hungarian patients have access to the newest medicines,” warns Katalin Szalóki, director of AIPM. “For that, however, we must act immediately.”
The association says failure to reform would push Hungary further toward the periphery of the transatlantic pharmaceutical market. That would weaken the country’s ability to attract launches, clinical activity and industry investment, while leaving patients with slower and less predictable access to therapies that could improve survival, quality of life or disease control.
Founded in 1992, AIPM Hungary brings together R&D-oriented pharmaceutical companies. Its 27 member companies account for more than half of the Hungarian pharmaceutical market. The organization says its objective is to ensure that Hungarian patients can access the latest treatment options based on modern medical discoveries as widely and as early as possible. It is the Hungarian member association of the European Federation of Pharmaceutical Industries and Associations, which represents the interests of innovative pharmaceutical manufacturers at both the national and European levels.
This article was first published in the Budapest Business Journal print issue of July 17, 2026.
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