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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.

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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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France Records 5,764 Excess Deaths During Deadliest Heatwave Since 2003

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At least 5,764 excess deaths were recorded in France during last month’s record-breaking heatwave, making it the country’s deadliest heat event since 2003, according to new figures from the national public health agency.

Between June 17 and July 2, 21,674 people died in France, compared with an estimated 15,910 deaths expected under normal conditions, Santé publique France said in a bulletin published Wednesday.

The agency described the figure as the highest excess all-cause mortality recorded during a heatwave since 2003. That year’s extreme heat event caused nearly 15,000 deaths across France.

The latest heatwave was notable for its timing, intensity and duration. It struck early in the summer, when schools and workplaces were still operating normally, and exposed almost the entire French population to extreme temperatures.

For the first time, the public health agency recorded excess all-cause mortality across every age group from 15 years old and above. The agency said the pattern demonstrated the exceptional intensity and prolonged nature of the heat exposure.

People aged 75 and over accounted for around two-thirds of the provisional death toll, with at least 3,719 excess deaths recorded in that age group. However, deaths also increased among younger adults, making the event different from many previous heatwaves, when the impact was concentrated mainly among the elderly.

Mortality rose in hospitals, private homes and nursing homes. Almost half of the excess deaths occurred in hospitals, according to the preliminary data.

Santé publique France stressed that the excess deaths cannot yet be directly attributed to heat in every individual case. However, the scale and distribution of the increase point to the wider health impact of the extreme temperatures.

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The agency said the findings showed the need for governments and health authorities to introduce prevention and response measures before temperatures reach crisis levels.

“These impacts highlight the importance of implementing management and prevention measures to reduce the impact of heat on the population without waiting for health impacts to become apparent,” the agency said.

The French figures came as other Western European countries reported thousands of additional deaths during a heatwave in early July. Preliminary estimates suggested more than 4,000 people died across the region during that period.

The World Health Organization’s European office called on governments at the end of June to treat extreme heat as a major health crisis and strengthen the ability of health systems to respond.

Public health officials have warned that longer and more intense heatwaves are placing growing pressure on hospitals, care facilities and emergency services, increasing the need for early warnings and stronger protection measures.

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Up to Five Cups of Coffee a Day May Be Safe for Most Adults, Review Finds

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Drinking up to five cups of coffee a day may be safe for most adults and could be associated with a lower risk of several health problems, according to a major review by the American Heart Association.

The review found that consuming up to 400 milligrams of caffeine a day, roughly equivalent to five cups of caffeinated coffee, does not generally increase cardiovascular risk for most adults. Moderate consumption, particularly between two and four cups daily, was also linked to the lowest risk of death in the research examined.

“The equivalent of up to five cups of caffeinated coffee per day without added sugars or fillers is safe and does not increase cardiovascular risk,” said Gregory M. Marcus, a co-author of the paper and professor of medicine at the University of California, San Francisco.

The analysis found that moderate coffee consumption may be associated with better heart health and a lower risk of conditions including heart failure, heart disease and stroke. Some individuals also appeared to have a lower risk of high blood pressure and type 2 diabetes.

Coffee is the main source of caffeine for many adults, but daily intake can also come from tea, chocolate, fizzy drinks and some over-the-counter and prescription medicines. The researchers said less is known about the effects of caffeine from these sources, particularly at high levels.

Energy drinks were highlighted as an area requiring further study because large amounts of caffeine and other ingredients may pose cardiovascular risks.

Caffeine is processed by the liver and usually reaches its highest concentration in the blood within about an hour of consumption. The way people respond to it varies widely, however, depending on genetics, metabolism, age and previous caffeine intake.

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Regular coffee drinkers may develop some tolerance, while others can experience strong effects from relatively small amounts.

“Although research suggests that caffeine consumption may be associated with certain cardiovascular benefits for some people, it’s important to remember that there is no ‘one-size-fits-all’ strategy for safe caffeine consumption,” Marcus said.

He added that an amount that is reasonable for one person could cause side effects such as heart palpitations, anxiety or sleep disruption in another.

The researchers also warned that the way coffee is prepared can affect its overall health impact. Large amounts of added sugar, flavoured syrups and high-calorie dairy products can significantly increase calorie intake and may reduce the potential benefits associated with coffee itself.

The findings suggest that moderate, unsweetened coffee consumption can fit into a healthy lifestyle for many adults, but individual tolerance remains an important factor when deciding how much caffeine to consume.

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Summer Heat Linked to Seasonal Depression as Mental Health Concerns Rise Worldwide

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Seasonal depression is commonly associated with the short, dark days of winter, but health experts are warning that hot weather and prolonged heatwaves can also trigger a lesser-known form of the condition during the summer months.

Medical professionals say Summer Seasonal Affective Disorder (SAD) is a recognised type of depression that follows a seasonal pattern and can significantly affect daily life. Although far less common than winter SAD, experts stress that it should be treated as a serious mental health condition.

According to a recent study, summer SAD affects around 0.57% of the global population, compared with about 5% for the winter form of the disorder. Rising temperatures, frequent heatwaves and tropical nights have been identified as factors that can contribute to symptoms in vulnerable individuals.

Unlike winter depression, which is often linked to reduced daylight and social isolation, summer SAD is associated with excessive heat, disrupted sleep and physical discomfort. Symptoms may include insomnia, loss of appetite, anxiety, agitation and persistent low mood. In severe cases, the condition can interfere with work, relationships and everyday activities.

Adam Borland, a clinical psychologist at the Cleveland Clinic, said people experiencing symptoms may benefit from maintaining a regular daily routine, limiting exposure to extreme heat and making sleep a priority. He added that anyone with severe or persistent symptoms should seek professional medical care.

The warning comes as mental health conditions continue to rise across the world. A recent analysis from the Global Burden of Disease Study, published in The Lancet, estimated that approximately 1.2 billion people, or around 15% of the global population, were living with a mental health condition in 2023.

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The study found that the number of people affected by mental health disorders increased by 95% between 1990 and 2023. During the same period, mental disorders climbed from the 12th to the fifth leading cause of health loss worldwide.

Major depressive disorder and anxiety disorders recorded some of the sharpest increases. Cases of major depression rose by 131%, while anxiety disorders increased by 158%, making them the two most common mental health conditions globally.

Researchers behind the Global Burden of Disease Study said meeting the growing demand for mental health services should be regarded as a public health priority, particularly for vulnerable groups.

The situation is also a concern across Europe. The World Health Organization estimates that one in six people in the European region, around 140 million individuals, lives with a mental health condition. Despite the high number of cases, only one in three people suffering from depression receive the treatment they need.

Health experts have also highlighted the lasting impact of the COVID-19 pandemic. Depression and anxiety among young people have increased by an estimated 25% since the pandemic, while suicide has become the leading cause of death among people aged 15 to 29 in the European region.

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