Life sciences is a high-stakes sector where antitrust enforcement is testing the boundaries of competition law. The focus differs sharply across jurisdictions. Competition law is being used – sometimes explicitly, sometimes implicitly – as a lever to advance national healthcare priorities: lowering prices, controlling budgets, accelerating access, or safeguarding domestic innovation. Companies operating globally must navigate not one coherent approach to dominance, but several parallel theories that reflect political agendas as much as competition doctrine. Here, we examine how those theories are playing out across the US, EU, UK, and Asia-Pacific.
United States
In the US, the Trump Administration has made lowering prescription drug prices a headline policy objective. Its “most-favored-nation” executive order directs federal agencies – including the FTC and DOJ – to push drug prices toward levels seen in other developed economies. The Administration has coupled this mandate with direct negotiations to reduce prices for specific drugs and has stated its intention to “deploy every tool in [its] arsenal” against what it considers abusive pricing.
In practice, this approach reinforces an aggressive enforcement posture. Recent FTC cases targeting pricing conduct and exclusionary rebate schemes (e.g., rebates conditioned on limiting access to lower-cost generics or biosimilars) as well as agency listening sessions on formulary steering demonstrate how antitrust is being integrated into a broader affordability agenda. Beyond this, the FTC also remains focused on other forms of foreclosure-type conduct that threatens drug competition, including pay-for-delay settlements, product hopping, exclusive supply or authorized-generic agreements, and alleged misuse of Orange Book listings and safety programs.
European Union
In the EU, the authorities are primarily targeting non-pricing conduct that they believe impedes the timely entry of generics or biosimilars – especially conduct that manipulates intellectual property to extend exclusivity. The European Commission has pursued investigations into abusive patent strategies framed as “gaming” the system, and national authorities are following suit. The Italian Antitrust Authority’s scrutiny of cross-Atlantic patent settlements for biosimilars illustrates how regulators now look beyond domestic borders when they consider whether global arrangements affect EU entry.
These cases reveal a deeper shift. Regulators are placing increasing weight on internal documents and presenting them as evidence of a conscious strategy to block competition. Lifecycle management strategies that were once viewed as legitimate portfolio decisions may now be interpreted as attempts to extend market power – particularly where the underlying IP claims appear weak. For originators, this means patent enforcement and settlement strategies will be judged not only on legal validity but also on their perceived competitive rationale.
Authorities across the EU are also widening their lens to include denigration and disparagement by dominant firms, demonstrated by 2024 fines against Teva for both practices and commitments accepted from Vifor in a separate disparagement case. These issues have remained prominent in 2025, with dawn raids in the vaccine sector based on suspicions of anticompetitive disparagement.
United Kingdom
In the UK, enforcement blends the EU’s non-pricing focus with a continued interest in pricing conduct, reflecting the pressure on the NHS to manage costs. The EC’s recent Vifor Pharma case, followed by the UK CMA’s decision to mirror and extend commitments for the benefit of NHS patients, shows how statements about a competitor’s safety or efficacy can be treated as exclusionary conduct. The CMA secured a £23 million payment to the NHS in closing the investigation.
The CMA’s willingness to piggyback on EC investigations suggests that UK authorities will use alignment with EU enforcement to secure stronger domestic outcomes, particularly where remedies can be adapted to the needs of patients or NHS procurement. Regulators argue that inaccurate or incomplete claims can restrict entry as effectively as pricing or supply strategies. The expectation is clear: claims must be objectively verifiable, and communications should focus on a company’s own products rather than negative assertions about rivals.
The UK’s pricing and rebate policy is shaped by the Voluntary Scheme for Branded Medicines Pricing, Access and Growth, which caps branded medicines spending and requires rebates when thresholds are exceeded. Disputes over high rebate percentages have exposed tension between government and industry. Pricing, rebates, and investment are likely to remain focus areas as global pharma companies navigate the tightrope between the US political agenda and cost pressures in the UK and Europe.
Asia-Pacific
Across Asia, enforcement remains centered on traditional pricing practices such as price-fixing, bid-rigging, excessive pricing, and resale price maintenance, reflecting the overriding priority of affordability and cost control in national healthcare agendas. Authorities in China, Japan, South Korea, Malaysia, and Indonesia have continued to pursue high-impact pricing cases, especially in markets that affect consumers directly. China’s State Administration for Market Regulation remains particularly active in the active pharmaceutical ingredient (API) sector, and there is no indication that its focus will ease as domestic cost pressures persist.
Diverging Theories, Converging Pressure
A single thread connects these otherwise divergent approaches: regulators see competition law as a lever to influence healthcare outcomes, even when the underlying conduct theories differ.
For companies operating in the sector, traditional antitrust analysis – market definition, dominance assessment, pricing effects – must now be matched with an understanding of the political and fiscal context in which authorities are acting. The risk is no longer limited to high prices or restrictive agreements; it extends to:
- Patent strategy and settlement structures;
- Scientific communications;
- Lifecycle management and integration decisions; and
- Assertions about rivals and even the tone of market-facing materials.
These same conduct theories are increasingly serving as templates for private damages actions, which are growing more coordinated and technologically sophisticated across jurisdictions. The result is a more assertive, less predictable enforcement environment in which conduct once viewed as peripheral to competition policy may now be treated as central. Success will ultimately depend on designing compliance strategies that account for potentially divergent but increasingly intertwined regulatory priorities.
For a deeper dive on merger control enforcement, as well as changes in the foreign direct investment screening environment, please see our 2026 10 Key Themes report.
