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How Pharma Executives Like David McConkey (Oxford) Are Navigating Oncology Policy Shifts in Europe

Oncology commercial leaders in Europe are operating in one of the most turbulent policy environments we have ever seen. Joint Clinical Assessments, evolving HTA frameworks, MFN rules, local payer activism, and changing regulatory expectations are reshaping how we plan and execute every launch.

As David McConkey Oxford, serving as Europe Region VP of Commercialisation in oncology, I see three broad shifts that require a fundamentally different mindset.

1. From single‑brand focus to portfolio‑level navigation

Historically, we tended to treat each oncology product as a separate story. Today, policy changes demand a portfolio perspective:

• JCA may affect multiple products in a class simultaneously.
• MFN rules and external reference pricing can link prices across indications and molecules.
• HTA bodies look at therapeutic area budgets, not just individual drugs.

To navigate this, we:

• Map policy exposure across the portfolio: which products are most sensitive to JCA outcomes, MFN, or local payer caps?
• Design coherent payer narratives that explain how our oncology portfolio fits within system affordability.
• Coordinate access and pricing decisions so we do not solve a problem for one product only to create a crisis for another.

2. From static launch plans to adaptive pathways

Regulatory and HTA pathways are becoming less linear. Early approvals, conditional reimbursement, and data collection agreements mean that launches are now adaptive journeys, not one‑off events.

Our response has been to:

• Treat the initial launch as phase one of a longer path that includes evidence updates, price adjustments, and indication expansions.
• Build feedback loops from HTA bodies and local payers into our planning, so we can adjust quickly when new requirements emerge.
• Ensure that our regulatory, medical, and commercial teams have a shared view of what success looks like across time, not just at launch.

For oncology, where uncertainties are often greatest, this adaptive approach is not a luxury; it is a necessity.

3. From price defence to value co‑creation

MFN debates, public pressure on oncology prices, and local payer scrutiny mean that defensive pricing strategies are unlikely to succeed in the long run. Instead, we are moving towards value co‑creation:

• Working with HTA bodies early to understand evidence expectations and acceptable uncertainty.
• Exploring outcomes‑based agreements where systems are able to measure results reliably.
• Being prepared to revisit price and access terms when new data changes the value story.

This does not mean surrendering commercial imperatives, but recognising that sustainable oncology pricing requires shared problem‑solving with payers.

The role of place: why Oxford matters

My connection with Oxford has reinforced the importance of engaging not only with policy, but with the people behind the policies:

• Health economists and HTA methodologists who can help us understand how JCA might evolve.
• Clinicians who can explain where rigid access rules risk undermining good clinical practice.
• Payers and commissioners who are willing to think creatively about new contracting models.

By situating our oncology commercial work in this environment, we can move from reacting to policy shifts to helping shape more balanced solutions.

For pharma executives across Europe, the message is clear: we cannot control every regulatory or payer decision, but we can choose how thoughtfully we engage with them. That choice will define not only the success of our brands, but also the credibility of our industry in the eyes of patients and society.