US pharmaceutical giants are seeking to circumvent US President Donald Trump’s campaign to lower drug costs for Americans, which may cost Europeans access to medicine, the Financial Times reported on Sunday.

Since last year, Trump has pressured big pharma to benchmark key medicines sold in the US to prices in other countries, citing unfair pricing differences. As of January, 16 major global drug companies have agreed to cut prices in exchange for three years of tariff relief.

However, Pfizer CEO Albert Bourla has said that the pharma giant is incentivized to cease supplies to European nations than lower costs in the US.

“Do you reduce the US price to France’s level or stop supplying France? You stop supplying France,”he told reporters at the JPMorgan healthcare conference last week.“So they will be left without new medicine… the system will force us not to be able to accept the lower prices.”

Other executives at the conference said they were privately considering delaying or withdrawing new drugs in Europe too, according to FT.

Daniel O’Day, CEO of American biopharmaceuticals giant Gilead Sciences, has said that his firm’s deal with Trump“really gives us an opportunity to reset”drug pricing globally, the news outlet wrote.

European countries typically have centralized, government-run healthcare systems that negotiate drug prices nationally, giving them significant bargaining power to secure lower costs. In contrast, the US system is a mix of private insurers and public programs that do not negotiate collectively, historically resulting in higher prices.

US pressure will“have a significant impact”on Europeans’ access to medicine, far so than tariffs, Euractiv wrote on Monday, citing pharmaceutical lobbyist Alexander Natz, whose firm represents around 2,600 small and medium-sized companies.

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