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Europe Pays Less for Medicines Than the U.S., but Prices Still Vary Widely by Country

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As former U.S. President Donald Trump reignites debate over America’s high drug prices, attention is once again turning to how Europe manages to pay far less for the same medicines—even if pricing remains inconsistent across the continent.

Trump, speaking to journalists on Monday, criticized the European Union for what he called “brutal” and “nasty” tactics in negotiating with pharmaceutical companies. He announced a proposal to link U.S. drug prices to the lowest rates paid by other wealthy nations, declaring: “We’re going to pay what Europe pays.”

According to a RAND Corporation analysis, the U.S. spent $617.2 billion (€542.7 billion) on pharmaceuticals in 2022—nearly three times the €205.3 billion spent by 24 European countries combined.

While it’s true that Europeans generally pay less, the picture within the region is far from uniform. A report by the World Health Organization (WHO) found that drug prices vary widely across Europe, largely due to confidential negotiations with drugmakers, national budget constraints, and differing approaches to price regulation.

In Switzerland, per capita spending on medicines reached €525, whereas Croatia spent just €262. These discrepancies reflect not only national income levels but also the complex and opaque nature of price-setting in the region. “There’s essentially no transparency,” said Huseyin Naci, an associate professor of health policy at the London School of Economics.

Many European countries base their pricing on what other nations pay and use cost-effectiveness assessments to determine value. England and Sweden emphasize whether a drug justifies its cost, while Germany looks at how much additional benefit it offers over existing treatments.

Still, costs have risen across the continent. In Germany, for instance, hospital drug prices increased 11.5% from 2012 to 2022, while retail pharmacy prices rose 2.6% in the same period. Health insurers have warned that rising prices are putting pressure on public health budgets.

If U.S. policy changes or drug companies push European nations to raise their prices, it would be highly disruptive,” Naci said.

European nations also differ in how drug costs are shared between public systems and individuals. In Cyprus, 90% of medicine expenses were covered by government or mandatory schemes in 2022. In Bulgaria, that figure was only 23%. Meanwhile, patients in some countries still pay out-of-pocket or through co-payments, depending on the condition being treated.

Despite lower overall spending, experts caution that European healthcare systems are already stretched thin. “There’s not much room left to absorb higher pharmaceutical costs,” Naci said.

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Global Nurse Shortage Worsened by European Reliance on Foreign Healthcare Workers, WHO Warns

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A growing global shortage of nurses is being deepened by the increasing dependence of wealthier European nations on foreign-born healthcare professionals, according to a new report released by the World Health Organization (WHO) and partner organizations.

The report highlights a shortfall of 5.8 million nurses worldwide, with disproportionate reliance on international recruitment in Europe aggravating disparities between richer and poorer nations. While the global nursing workforce grew to 29.8 million in 2023—up from 27.9 million five years earlier—the gap in supply remains significant, particularly in low-income regions.

We cannot ignore the inequalities that mark the global nursing landscape,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus.

Europe and Central Asia collectively host 7.2 million nurses, with projections suggesting the region will require one million more by 2030. Europe currently has 76.9 nurses per 10,000 people—five times the rate found in Africa and the Eastern Mediterranean. Yet this apparent abundance masks deeper structural issues.

Ageing Workforce and Limited Recruitment

One of the key challenges is an ageing workforce. In 2023, only 31% of nurses in Europe were under the age of 35, while 21% were aged 55 or older. In Eastern Europe, older nurses outnumber younger ones—a trend that raises concerns about long-term workforce sustainability.

The report found that in around 20 countries—most of them in Western Europe—the number of new nurses is not keeping pace with healthcare demand. This is largely driven by retirements and the increasing needs of ageing populations.

Dependence on International Nurses

In 23 European countries surveyed, 14% of the nursing workforce was foreign-born and another 10% had trained abroad. The WHO report criticized high-income nations for underinvesting in their own nursing education systems, leading to an overreliance on talent from lower-income countries. This trend, it warned, is worsening workforce shortages in regions already struggling to meet healthcare demands.

There are striking inequalities in workforce distribution which have driven a surge in international recruitment and inequitable migration patterns,” said Howard Catton, CEO of the International Council of Nurses.

Training and Retention Challenges

Despite these concerns, Europe boasts a more developed training pipeline than most regions. In 2023, there were 42.7 new nurse graduates per 100,000 people in Europe, compared to a global average of 25.3. Much of this new talent comes from Central Asia, while Western Europe lags behind in nurse production.

European nurses also benefit from the highest starting salaries globally, with average entry-level pay at $2,508 (€2,205) per month. Additionally, 78% of European countries offer leadership development programmes for nurses—the highest rate globally.

The WHO report urges wealthier European countries to ramp up investment in domestic training programmes and implement stronger incentives to retain nurses, warning that continued reliance on international recruitment risks deepening global healthcare inequalities.

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Early-Onset Cancer Rates Rising in U.S., But Deaths Mostly Stable, Study Finds

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A new U.S. government study has revealed that while cancer diagnoses among people under 50 are on the rise, the overall death rates for most types of cancer in this age group remain stable.

Published Thursday in the journal Cancer Discovery, the study is one of the most comprehensive assessments to date of early-onset cancers, analyzing data from more than two million cases diagnosed in Americans aged 15 to 49 between 2010 and 2019.

The findings show that 14 out of 33 cancer types had increasing incidence rates in at least one younger age group. The most significant increases were seen in breast, colorectal, kidney, and uterine cancers. Women accounted for about 63 percent of the early-onset cases.

This pattern generally reflects something profound going on,” said Tim Rebbeck of the Dana-Farber Cancer Institute, who was not involved in the study. “We need to fund research that will help us understand why this is happening.”

The study found that, compared to 2010 data, there were 4,800 more breast cancer cases, 2,000 additional colorectal cancers, 1,800 more kidney cancers, and 1,200 extra uterine cancers by 2019.

Despite the rising numbers, researchers emphasized a key reassurance: death rates for most of these cancers are not increasing. However, exceptions were noted—colorectal, uterine, and testicular cancers saw slight rises in mortality among younger adults.

The causes behind the rise in early-onset cancers are not fully understood. The study’s datasets do not include information on potential risk factors such as obesity, lifestyle, or access to healthcare. However, researchers, including lead author Dr. Meredith Shiels of the National Cancer Institute, highlighted obesity as a possible driver.

Several of these cancer types are known to be associated with excess body weight,” said Dr. Shiels. She also pointed to advances in detection and changing screening practices as possible contributors to earlier diagnoses.

Breast cancer trends may also be influenced by shifting reproductive patterns, such as women having children later in life, which has been associated with increased cancer risk due to fewer years of pregnancy and breastfeeding—factors known to lower risk.

Not all cancer types followed the upward trend. Rates of more than a dozen cancers, including lung and prostate cancer, are decreasing among younger people. Researchers attribute the lung cancer decline to reduced smoking rates, while updated PSA screening guidelines are likely behind the drop in prostate cancer diagnoses.

Experts plan to convene later this year to further investigate the growing early-onset cancer burden and explore targeted prevention strategies.

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UK Scientists Develop Tool to Measure ‘Heart Age,’ Offering New Insights for Cardiovascular Health

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Researchers in the United Kingdom have developed a new tool that can determine how old a person’s heart is in comparison to their actual age, offering a potential breakthrough in the early detection and prevention of cardiovascular disease.

The study, led by scientists at the University of East Anglia (UEA), examined magnetic resonance imaging (MRI) scans from 557 individuals across the UK, Spain, and Singapore. Of those, 336 participants had known health risk factors such as obesity, high blood pressure, or diabetes.

Using these scans, the researchers measured structural and functional markers of cardiac health — including the size of the heart’s chambers and how effectively it pumps blood. These indicators were then used to create an algorithm that calculates the heart’s “functional age.”

The findings, published in the European Heart Journal, revealed that individuals with cardiovascular risk factors had hearts that were, on average, 4.6 years older than their chronological age. In people with obesity, the gap was even wider, indicating faster cardiac ageing.

People with health issues like diabetes or obesity often have hearts that are ageing faster than they should – sometimes by decades,” said Dr. Pankaj Garg, a cardiologist and lead author of the study. “This tool gives us a way to visualize and quantify that risk.”

While the tool shows promise, researchers noted some limitations. The model does not account for how long patients had lived with their conditions, and the study group primarily included older individuals who had survived with these health issues — raising concerns about survivor bias. The relatively small sample size also means the tool needs broader validation before it can be widely adopted.

Despite these limitations, the research team believes the tool could have valuable clinical applications in the future. Dr. Garg said it may help doctors counsel patients more effectively about their cardiovascular health and recommend lifestyle changes or treatments to slow heart ageing.

By knowing your heart’s true age, patients could get advice or treatments to slow down the ageing process, potentially preventing heart attacks or strokes,” he said. “It’s about giving people a fighting chance against heart disease.”

The team hopes the tool could eventually be integrated into routine care, empowering patients to take early steps toward improving their heart health through diet, exercise, and medical intervention.

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