David Carr, PhD | Vice President, Global Pricing & Market Access
Mary Wake | Engagement Manager, Global Pricing & Market Access
Richard Macaulay | Senior Vice President, Global Pricing & Market Access
A clear message ran through last week’s World EPA 2026 Congress: the old playbook for access, evidence, and value is under real strain. Policy, politics, and uncertainty are shaping decisions in real time. As a result, companies are being pushed to rethink not just what they bring to market, but how they position value, generate evidence, and work with health systems.
This recap captures the key themes, concerns, and strategic signals from World EPA Congress 2026 that market access, policy, and evidence teams should keep in mind as they plan for the year ahead.
Geopolitical, economic, and policy uncertainty were a given across discussions, with Most Favored Nation (MFN) the key talking point in the hall and the topic of Precision AQ's standing-room-only presentation. Rather than trying to predict the future, speakers emphasized preparation: scenario planning, signal monitoring, and making small, reversible decisions before scaling. The idea was simple: clarity and readiness matter more than confidence.
At the same time, global access strategies are evolving. Launches are becoming more synchronized across markets, while the rise of the Global South is changing how companies think about sequencing, partnerships, and long-term impact. There was growing interest in more collaborative models that balance competition with access and health outcomes.
One of the strongest themes was the need to move beyond narrow, product-level value stories. Speakers repeatedly argued for a wider definition of value that includes population health, productivity, and economic contribution. Health is increasingly being framed as an investment, not just a cost, and life sciences as part of industrial strategy and national resilience.
That shift comes with a mindset change, too. Several sessions talked about moving from being medicine developers to becoming “lifespan partners,” working alongside health systems on prevention, diagnostics, and integrated care. Outcomes-based agreements are part of that conversation, but there was honesty about how hard they are to make work, and how often they fail without genuine partnership.
The introduction of Joint Clinical Assessment (JCA) in Europe featured heavily, particularly its impact on rare diseases. While there’s hope it will improve quality and efficiency over time, the near-term reality feels more rigid. Companies are losing the ability to learn from sequential HTAs, and there’s real uncertainty around how flexible JCA will be on real-world evidence, registries, and novel endpoints.
The response? Start earlier and think more holistically. Integrated, cross-functional evidence planning, well upstream of pivotal trials, was seen as critical. Patient and clinician engagement, better use of indirect comparisons, and smarter use of real-world data were all discussed as ways to manage uncertainty more credibly.
Pricing discussions for rare and ultrarare therapies were sobering. Even not-for-profit models struggle under fixed regulatory and compliance costs that don’t scale with patient numbers. The takeaway was uncomfortable but clear: today’s frameworks weren’t built for these therapies.
Finally, many speakers emphasized the importance of structure and governance. The organizations that cope best are fully integrated, policy-aware, and clear on what success looks like. Market access can’t be an afterthought; it needs a seat at the table, aligned with clinical development, political affairs, and commercial strategy from the start.
To help navigate the choppy waters, get in touch with Precision AQ experts, and let’s discuss your value, access, and pricing needs.