“The price that we pay is not the real price of the medicine”: How the pharmaceutical price architecture facilitates financial accumulation

Susi Geiger and Théo Bourgeron

Chapter 17 in Handbook of Pharmaceutical Science and Technology Studies, 2026, pp 273-288 from Edward Elgar Publishing

Abstract: This chapter investigates how financial accumulation is enabled through the architecture of the current pharmaceutical pricing system. We describe the proliferation of prices that structures European pharmaceutical markets and consider three main sites where accumulation is embedded into this architecture: we first examine how this architecture is driven by the increasingly speculative prices of pharmaceutical patents, which have been turned into real financial assets over the past decades and whose prices have skyrocketed. We then explore how this trend has been enabled by the shaping of differentiated prices at the European level, where savings from generic medicines, for instance, are used to subsidize highly priced medicines at the “top” of the pricing architecture, for instance for orphan diseases. We also interrogate the impact of European reference pricing in fuelling the rapid increase of pharmaceutical prices in these “top” layers. We finally detail how recent initiatives have sought to curb this price spiral, leading to some adjustments in day-to-day negotiations between national health insurers and pharmaceutical corporations. Overall, this chapter provides a crucial understanding of how the architecture of pharmaceutical prices has been organized in Europe to support the transformation of medicines into financial assets.

Keywords: Financialization; Assetization; Markets; Pricing; Price architecture; Innovative medicines (search for similar items in EconPapers)
Date: 2026
ISBN: 9781035338443
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