Nearly 50 life-saving drugs delayed or cancelled for Canadian patients due to U.S. pricing policy
A U.S. Most Favoured Nation pricing rule is forcing drug companies to stall launches in Canada to protect their American market strategy. Sixteen medicine launches have been cancelled outright.
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Nearly 50 life-extending and life-saving drugs have cancelled or delayed their Canadian launches in the past year due to a U.S. pricing policy—some already approved by Health Canada—leaving Canadian patients without access to cutting-edge treatments.
According to a survey by EY of 31 pharmaceutical and life sciences companies, 16 medicine launches in Canada have been cancelled directly because of U.S. President Trump's Most Favoured Nation (MFN) policy, announced by executive order in May 2025. Another 32 drugs have seen their rollouts delayed. The MFN policy dictates that Americans must pay the best price for prescription drugs, effectively requiring U.S. prices to match or undercut prices negotiated in other countries.
Dr. Michelle Hladunewich, a nephrologist and Physician-in-Chief at Sunnybrook Health Sciences Centre, warned: "Canadians need to know that in the not-too-distant future, the cutting-edge medications that would help them with their rare disease may simply not be available to them."
Drug development costs average $3.5 billion and take 10 to 15 years, according to Innovative Sciences Canada, which represents the pharmaceutical industry. Much of that cost is recouped in the U.S., where prices are significantly higher than in other developed nations. The MFN policy creates upward pressure on prices globally, as companies must decide whether to accept lower reference prices that would affect their U.S. revenue or withdraw from lower-priced markets entirely.
In Canada, drug pricing involves multiple steps: Health Canada approval, evaluation by Canada's Drug Agency for cost-effectiveness, negotiation by the pan-Canadian Pharmaceutical Alliance on behalf of all provinces, and individual provincial formulary listings. Companies face the risk that negotiated Canadian prices become benchmarks for U.S. pricing, undermining their American margins.
"A pharmaceutical company ends up with a situation where it either has to force aggressive pricing negotiations in domestic markets or end up having an unfavourable lower price serving as a reference price for its U.S. price," said Rambod Behboodi, Senior Counsel with Borden Ladner Gervais LLP. The concern materializes now: Novartis announced it would not launch Vanrafia, a drug aimed at slowing IgA nephropathy progression, in Canada—despite Health Canada approval—citing MFN pricing risks.
Which specific drugs among the 48 delayed or cancelled are highest-priority treatments for Canadian patients?
Will the federal government negotiate with the U.S. or pursue other policy measures to address the impact?
We'll update this story as answers emerge.
By the numbers
How many drug launches in Canada have been cancelled due to the U.S. MFN pricing policy?
16 medicine launches in Canada have been cancelled directly because of U.S. President Trump's Most Favoured Nation policy, which was announced by executive order in May 2025.
How many additional drugs have seen delayed Canadian launches?
32 drugs have had their Canadian rollouts delayed due to the MFN pricing policy, according to an EY survey of 31 pharmaceutical and life sciences companies.
What is the average cost and timeline for drug development?
Drug development costs average $3.5 billion and takes 10 to 15 years, according to Innovative Sciences Canada.
What drug did Novartis decline to launch in Canada?
Novartis announced it would not launch Vanrafia, a drug aimed at slowing IgA nephropathy progression, in Canada despite receiving Health Canada approval, citing MFN pricing risks.
