What Europe Can Teach Washington About Drug Pricing: A Conversation with OHE's Graham Cookson
- Jul 23
- 2 min read
Graham Cookson, Chief Executive of the Office of Health Economics (OHE), joined a conversation with We Work for Health Executive Director Dan Leonard to unpack pressing questions surrounding prescription drug pricing policy and its effects across Europe's innovation ecosystem.
Founded in 1962, OHE is the world's oldest independent health economics research organization. Though headquartered in the UK, its work spans the globe.
Drawing on his expertise, Cookson offered a candid analysis of how price control policies are playing out in Europe — and a cautionary note for Washington, where similar proposals remain under active discussion.
A Bigger Problem Than Drug Pricing
Cookson argued that most policymakers who support MFN and price controls are pursuing a legitimate goal: lowering healthcare costs. But he cautioned that framing the issue narrowly as a pricing problem misses the bigger picture.
He also pointed to a longstanding dynamic in which lower prices in some countries have effectively shifted more of the cost burden onto others, including the United States.
Could a "NATO Model" Work for Prescription Drug Spending?
Leonard and Cookson explored a potential solution: a coordinated commitment, similar to NATO defense-spending targets, in which countries agree to raise the share of GDP devoted to medicines. Cookson pointed to the UK's recent pledge to double pharmaceutical expenditure as a percentage of GDP over the next decade as an early example of this approach — one that could expand access to innovative treatments while distributing the cost of innovation more equitably across wealthier nations.
Rethinking the CBO's Innovation Model
Leonard also asked Cookson about recent a research paper he co-authored about the Congressional Budget Office’s modeling of drug pricing policies on pharmaceutical investment. His research found that the CBO's model, used to estimate how the Inflation Reduction Act would affect pharmaceutical investment, relied on an overly simplistic view of investor behavior and offered a false sense of precision about the policy's real-world impact on innovation.
Cookson noted that the model's shortcomings were particularly evident in its treatment of small-molecule drugs, which saw a sharp drop in investment following the IRA's passage — a consequence he said was inadequately anticipated at the time.
That critique carries fresh weight today, as U.S. policymakers weigh additional pricing measures and continue to lean on CBO scoring to guide those decisions.
Watch the full interview below