Novo Nordisk CEO Maziar Mike Doustdar shakes hands with U.S. President Donald Trump during an event to announce an agreement with Eli Lilly and Novo Nordisk to reduce prices of GLP-1 weight loss drugs during an event in the Oval Office of the White House in Washington, DC, U.S., November 6, 2025.
Jonathan Ernst | Reuters
Drug pricing has become one of the top issues for pharmaceutical companies this year, as the United States seeks to significantly reduce costs paid by consumers.
As the largest single market for most pharmaceutical and biotechnology companies, higher drug prices in the United States — often nearly three times more expensive than in other countries — are a key factor in the industry’s reliance on U.S. sales, with brand-name drugs commanding even higher premiums.
President Donald Trump has pushed for lower drug prices for Americans through so-called Most Favored Country drug pricing, under which prices in the United States are set at the lowest price paid by other wealthy countries. This could have a significant impact on companies’ balance sheets.
But exactly how exposed are Europe’s largest pharmaceutical companies to the US market?
Majority sales in the United States
Among the 10 largest biopharmaceutical companies in the Stoxx 600 Healthcare Index, five generate the majority of their total sales in the United States: RockNovo Nordisk, GSK, ArgenxAnd UCB.
Argenx is the most exposed, with 85% of its total sales coming from the United States during the last reporting period.
The least exposed are the German Merck KGaA and Bayerwith approximately 30% of sales coming from the United States. Merck and Bayer have diversified businesses that extend beyond pharmaceuticals, while Roche also has a large diagnostics division.
In the meantime, AstraZenecathe largest company in the FTSE 100, generates 42% of its turnover in the United States and aims to increase this share as it targets a turnover of $80 billion by 2030. In its third quarter results report, the company, which has a broad portfolio of blockbuster drugs including medicines for cancer, respiratory and diabetes, said it is implementing its strategy to strengthen its operations in the United States to “fuel growth”.
The Cambridge, UK-based company has also promised significant investment in the US, just like its peers. NovartisRoche and GSK, since Trump began his second presidential term.
Doing business
Trump’s efforts to reduce drug prices have led many companies on both sides of the Atlantic to strike deals with the administration.
In May this year, the president signed an executive order establishing MFN pricing of medicines. He also sent letters to 17 major drugmakers, asking them to reduce prescription prices in the United States to match levels charged abroad.
At the same time, Trump has pushed to relocate production of various goods, including pharmaceuticals, and threatened to impose triple-digit tariffs on drugmakers that don’t invest in U.S. manufacturing — further increasing pressure on companies to strike deals with his administration.
AstraZeneca, Novo Nordisk and other US pharmaceutical giants have already reached deals with Trump to lower the prices of their drugs in the country, although analysts say this may not have a significant impact on their bottom lines because of the way the deals were structured.
“[AstraZeneca’s] The MFN deal is more benign than one would like, but EU countries could see access to medicines reduced,” Jefferies analysts said in November.
On Wednesday evening, Bloomberg reported that heavyweights Roche and Novartis – Europe’s two largest pharmaceutical companies by market value – were close to reaching drug pricing deals with the Trump administration, which could be announced as early as Friday.
Both companies told CNBC they support the administration’s goal of lowering drug costs for Americans, but declined to confirm an imminent deal. Novartis said it was “in discussions with the administration”.
– Carolin Roth contributed to this report
