Assessing Innovation Competition in Pharma Mergers | Competition Policy Brief No 1/2024
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review can capture the dynamics of the market. The
pharmaceutical sector is highly regulated, including pricing and
reimbursement schemes at national level, which drives a
delineation of relevant geographic markets for marketed drugs
along national borders, while at the innovation or development
stage competition is often far wider, potentially at least EEA-
wide, or global.
In the second and third sections, this Brief will focus on the
substantive assessment of horizontal and non-horizontal effects
in pharmaceutical mergers with particular focus on their impact
on innovation. Given the high risk / high reward nature of
pharmaceutical research and development (“R&D”) and the
transparency regarding pharmaceutical pipeline products years
before they reach the market,
a transaction’s rationale may give
important insights into the parties’ expectations regarding their
future potential and the development of the competitive
landscape. A “big pharma” company buying a start-up may grant
the target the financial and operational capability to effectively
bring a product to market, with pro-competitive effect. However,
this ability to identify the new drugs’ characteristics, prospects
and target market also means that, in some cases, there is a risk
that the impact of the deal could be less positive. In the presence
of horizontal overlaps, the transaction could result in a
concentration of market power in the purchaser’s hands by
combining competing marketed (or soon-to-be marketed)
products, leading to higher prices or reduced quality. Alternatively,
the result of the acquisition could be that the purchaser
discontinues its own or the target’s R&D efforts, which can lead
to price increases or reduced choice. Indeed, academic studies
have suggested that some pharmaceutical companies may use
early-stage acquisitions as a way to ‘kill’ potential competitive
threats that may emerge in future.
Even if the target does not
compete with the purchaser in the same market, non-horizontal
concerns may arise: the combination of the merging parties may
enable the merged entity to foreclose rivals and capture a
greater market share once its product reaches the market.
Given the high stakes for patients and health systems, it is
imperative that competition concerns be resolved in a way that
ensures a competitive market structure on a lasting basis. In view
of this, the Commission's remedies policy in pharmaceutical
mergers is outlined in the fourth section.
The fifth section summarises the recent evolution of the
Commission's approach to jurisdiction. An unusual feature of
In the pharmaceutical industry, pipeline drugs go through several
development stages, starting with preclinical trials in laboratories on
animals, and later moving on to clinical trials on humans. Clinical trials
in humans (so called “Phase I”, “Phase II” and “Phase III” clinical trials,
see further footnote 16) are strictly regulated to ensure the protection
of trial subjects and the reliability of the results. The results of these
trials are published.
See, for example, Cunningham, C., Ederer, F. and Ma, Song, Killer
Acquisitions, J. of Political Econ., (Mar. 2021), vol. 129, no. 3: 649–702.
The Commission has commissioned an ex post evaluation to assess the
prevalence of killer acquisitions in the pharmaceutical industry and
determine what are the key features of such killer acquisitions – this
study is in progress. The risk that M&A can result in the discontinuation
of pipelines is also identified in European Commission, Directorate-
General for Research and Innovation, Pang, T., Folwell, B., Osborne, A. et
al., Study on the impact of mergers and acquisitions on innovation in
the pharmaceutical sector, Publications Office of the European Union,
2020, https://data.europa.eu/doi/10.2777/323819.
pharmaceutical transactions is the lengthy development process
for medicines – on average, it takes 12-15 years from discovery
to bring a drug to market.
However, the promise and potential of
new medicines is at times clear at an early stage in this process,
meaning that even years before a product has been launched, a
start-up can be valued in the billions. The potential competitive
impact is therefore reflected in a target’s valuation by the
purchaser but not in its revenues, which is the metric used for the
notification thresholds set out in the EU Merger Regulation
(“EUMR”). This fifth section outlines the Commission's recalibrated
approach to referrals pursuant to Article 22 of the EUMR, which
enables it, in cooperation with EU Member States, to ensure that
transactions involving low-turnover but highly innovative targets
do not escape review.
Finally, in the sixth section, this Brief highlights the importance of
international cooperation and dialogue. Given that blockbuster
medicines are developed and commercialised at global scale,
competition agencies should ensure a consistent and coherent
approach to examining pharmaceutical mergers. Notably, the
sixth section outlines the recent conclusions of the inter-agency
working group between the Commission and the Canadian, UK
and US competition authorities.
1. Market definition
Whilst market definition in pharmaceutical mergers for marketed
drugs follows a well-established framework, the assessment of
innovation elements is more complicated because the precise
features of pipeline products may not yet be realised.
For commercialised products, in line with the Market Definition
Notice,
the Commission assesses substitutability from the
demand and supply sides. The general starting point for
pharmaceutical products is the Anatomical Therapeutic Chemical
(ATC) Classification System devised by the European
Pharmaceutical Market Research Association (“EphMRA”).
From
this starting point, the Commission assesses further whether it is
appropriate to distinguish between over-the-counter (“OTC”) and
prescription (“Rx”) medicines, indication denoted by the ATC 3
level,
the mode of action (such as topical or systemic), the mode
of delivery (such as oral or injectable) and, where relevant, the
OECD, Pharmaceutical Innovation and Access to Medicines (2018).
Commission Notice on the definition of the relevant market for the
purposes of Union competition law (OJ C 1645, 22.02.2024), “Market
Definition Notice”.
The ATC system is a hierarchical and coded four-level system which
classifies medicinal products by class according to their indication,
therapeutic use, composition, and mode of action. In the first and
broadest level (ATC 1), medicinal products are divided into the 16
anatomical main groups. The second level (ATC 2) is either a
pharmacological or therapeutic group. The third level (ATC 3) further
groups medicinal products by their specific therapeutic indications.
Finally, the ATC 4 level is the most detailed one (not available for all
ATC 3) and refers for instance to the mode of action (e.g. distinction of
some ATC 3 classes into topical and systemic depending on their way
of action) or any other subdivision of the group. Medicinal products are
classified according to the ATC system in the IMS Midas data base.
For OTC-sold drugs, the Commission may also use the Consumer
Health Classification (“CHC”, administered by IQVIA, an American
multinational company serving the combined industries of health
information technology and clinical research), which is equivalent to
ATC. See, e.g., Commission decision of 22 October 2021 in Case
M.10247 CVC/Cooper.