Fake weight-loss drugs are increasingly being advertised and sold across the EU, posing a serious public health threat, the bloc’s drugs regulator warned today. The European Medicines Agency said there has been a “sharp rise” in the number of illegal medicines marketed and sold as GLP-1 agonists, such as the popular semaglutide, liraglutide and tirzepatide, in recent months. Authorities have identified hundreds of sham Facebook profiles, advertisements and e-commerce listings promoting the fake drugs. These websites often mislead customers by using official logos and false endorsements, the EMA said. While genuine versions under the brand names Wegovy, Ozempic, Saxenda and Mounjaro are available through legitimate health services and with a prescription, the fake versions are “not authorised and do not meet necessary standards of quality, safety and efficacy,” the agency said. “Such illegal products pose a serious risk to public health. They may not contain the claimed active substance at all and may contain harmful levels of other substances,” the EMA warned. “People who use these products are therefore at a very high risk of treatment failure, unexpected and serious health problems and dangerous interactions with other medicines.”

After raising tariffs on steel and aluminum, U.S. President Donald Trump had a clear message for the pharmaceutical industry — you’re next. “It’ll be 25 percent and higher, and it’ll go very substantially higher over [the] course of a year,” he said when asked about semiconductors and pharmaceuticals during a press conference at his Mar-a-Lago residency in Palm Beach, Florida on Feb. 18. He later doubled down on his 25-percent tariff plan for Europe on Feb. 26. Generic drugmakers say that will lead to price increases for American patients, while analysts believe tariffs could also disrupt the delicate drug supply chain at a time when both the U.S. and the EU are trying to boost domestic medicine production after years of relying on cheaper Asian drugs. “Tariffs would affect both sides of the ocean,” Elisabeth Stampa, board chair at Spanish generics and active pharmaceutical ingredients firm Medichem, told POLITICO, underlining that Europe, which is a major supplier of medicines and their ingredients to the U.S., would experience export disruptions. Analysts also warn that counter-measures from Brussels — which the EU has promised — could end up exacerbating the continent’s supply problems. Whatever the consequences, tariffs on the industry would signify a new frontier in a trade war. Pharmaceutical products are normally excluded from tariffs because of a World Trade Organization agreement that dates back to 1994. “The general trend of the last decades has been to lower tariffs on pharmaceuticals globally to promote better access to medicines. Pharmaceuticals have not been at the forefront of recent tariff disputes,” said Justine Fassion, an international trade lawyer at Sidley. Many pharma companies have shrugged off tariff fears because of that text. GSK’s Chief Executive Emma Walmsley name-checked it last month when she said that medicines are typically exempt “in recognition of the fact that it matters for patients.” THE IRISH CASE Ireland’s investment agency, IDA Ireland, is also banking on that convention. Its chief executive Michael Lohan said this week that “one would hope that [WTO protocol on pharmaceuticals] would continue.” The Irish industry is particularly exposed: In 2023, the U.S. was the No. 1 country for Irish goods exports, with the United States buying products worth €54 billion. Of that, some €36 billion related to pharmaceuticals and chemicals. Lohan also played down the risk, saying the point in the supply chain at which a levy was applied was an important consideration. GSK’s Chief Executive Emma Walmsley name-checked it last month when she said that medicines are typically exempt “in recognition of the fact that it matters for patients.” | Leondardo Munoz/Getty Images “If you have an unfinished product, it needs to be finished and completed before it is turned into revenue and sale,” he said. “So the point at which the tariff is applied — is it the point of sale, or the point of transfer as it goes through a supply chain? I think that is a distinct difference.” A spokesperson for Ireland’s Department of Foreign Affairs said in an emailed statement that it “will work with EU partners to measure the impact of tariffs across all sectors, and calibrate our response on that basis.” “Increased protectionism is not in the interests of businesses or the global economic environment, and would not benefit the EU, Ireland or the U.S.,” it added. COUNTING THE COST Larger pharmaceutical companies with a big presence in Europe have also played down their concerns, saying they would be able to absorb the cost of any tariffs. Novo Nordisk CEO Lars Fruergaard Jørgensen said that while the company was “not immune” to the effects of tariffs, it is “confident” the business could weather the storm.  That’s despite Novo’s producing all of its weight-loss drug Wegovy’s active pharmaceutical ingredient, semaglutide, in Europe, from where it is exported to the United States. But smaller companies say they’re concerned about the potential impact on their business. “Such uncertainty complicates investment decisions and strategic planning, making it essential to prepare for various scenarios,” Jacopo Andreose, CEO at Angelini Pharma, told POLITICO in an email. The Italian firm makes products including eye drops and heat pads. The U.S. is the largest export market for European pharmaceutical products, accounting for 33 percent of the sector’s exports, he said, adding that “any trade barriers would impact supply chains, increase costs, and ultimately limit patient access to essential medicines” in the U.S. “Moreover, tariffs would drive up pharmaceutical prices in the U.S., affecting both patients and the entire U.S. health care sector.” “The climate of uncertainty is already damaging an EU that is struggling with competitiveness,” he added. The continent’s drug shortage problem complicates any decision by Brussels to impose countermeasures on the U.S. | Carlos Alvarez/Getty Images And pharma isn’t an agile industry. “You don’t move manufacturing overnight,” said Fassion, the Sidley lawyer. “Manufacturing in the pharma industry is subject to various regulatory constraints, so it can take time before you can move production from one country to another.” RETALIATION CONUNDRUM The big question is — would the EU retaliate? The European Commission said earlier this month it would react “firmly and immediately” to any levies, but when it comes to drugs, European patients could end up in the cross-hairs. Both the EU and the U.S. are drawing up measures to bolster their domestic drug production, but both are currently hugely reliant on Asia for medicines and their compounds, especially cheaper generics. The U.S. has one advantage: When supply issues arise in China or India, “pharmaceuticals tend to go to the U.S. over the EU because they pay more,” said Diederick Stadig, health economist at Dutch bank ING. Medicines for Europe, a lobby group for the continent’s generics sector, wants to use the moment to work together. “Europe or the U.S. (alone) will struggle to build competitive manufacturing,” its Director General Adrian van den Hoven said in an email. “We would be happy to work with the U.S. industry and government to tackle jointly concerns over dependence.” He added that Europe is a “major supplier” of generic medicines and active pharmaceutical ingredients.  Nevertheless, the continent’s drug shortage problem complicates any decision by Brussels to impose countermeasures on the U.S. “I assume the Commission is thinking about this, thinking ahead and preparing counter-tariffs,” Belgium’s Health Minister Frank Vandenbroucke said at a Polish presidency event in Brussels this month.  He cautioned: “I think we should be very careful because of unintended impacts on the supply chain.” In many European countries the price is fixed, so if a tariff is levied the product may simply disappear, he said. “I think we should be very careful.” Aging populations in Europe are creating increasing demand for medicines, and cheaper medicines in particular, said Stadig, the ING economist. But tariffs generally drive prices up. “This, and shortages, may inform the EU response when it comes to tariffs. This poses many complex questions to policymakers,” he said.  “I wouldn’t want to be the person making that decision.” Helen Collis contributed reporting to this article.

THE ROMA DOCTORS HEALING BULGARIA  As young professionals head to other countries, a marginalized community is filling the gap. By BORYANA DZHAMBAZOVA Illustration by Peter Gehrman for POLITICO This article is part of the Breaking out: Stories of Roma empowerment special report, presented by the Roma Foundation for Europe. On a hot June day, a group of Roma teenagers huddled over chemistry equations prepping for jobs the Bulgarian healthcare system is struggling to fill: doctors, nurses, dentists and pharmacists. The students are attending a course for Bulgaria’s rigorous medical school admissions exams, organized by Trust for Social Achievement, TSA, a Sofia-based nonprofit helping disadvantaged communities. Long excluded from higher education and professional careers, young Roma — a marginalized ethnic group making up about 10 percent of the Bulgarian population — are increasingly finding opportunities in fields that were once all but off-limits.  It’s a trend that goes beyond medicine —  but when it comes to healthcare, Roma medical staff aren’t just breaking into a new field, they’re answering a desperate need too. Bulgaria has a brain drain problem as young professionals are drawn to the benefits of working in richer countries. While the number of physicians is above EU average, they are mostly concentrated in big cities, and there are shortages in key specialties, according to a recent report conducted by the European Commission. Bulgaria is also one of the EU countries with the lowest number of nurses, along with Latvia and Greece. “[The program] produces doctors, nurses, and midwives who are much needed, especially in small towns,” said Miroslav Angelov, a Sofia-based cardiologist who became a doctor after attending a previous edition of the training program. “These people are the real changemakers,” Angelov said. THE REAL CHANGEMAKERS A career in medicine has traditionally been out of reach for most Roma people, who often face social inequality and exclusion from an early age: Access to kindergarten is limited, and most students are placed in all-Roma classes or even segregated schools in the later stages of their education. But thanks to nonprofit organizations like the Trust for Social Achievement things are starting to change: Between 2018 and 2024, the group taught more than 120 students and awarded 270 scholarships to get Roma kids into medical school. Ivailo Tournev, a leading neurologist based in Sofia, currently heads the program and plays a pivotal role in guiding these young students. He has been working closely with the Roma community for over two decades, organizing prep courses and training health mediators.“We knew it was crucial to train medical professionals from the Roma community, which was plagued by high child mortality, chronic diseases, and poor access to healthcare,” said Tournev. For many of the students, the program is the only opportunity they would have to pursue their dreams of a career in medicine. | Hristo Rusev/Getty Images Most of the students attending the TSA course succeed in completing their degrees and becoming medical professionals in leading hospitals in Sofia and across the country. In the last two editions of the course, 15 out of 17 of its secondary school graduates were accepted into a medical university.  These young doctors and nurses are reshaping perceptions both in the wider society and the Roma community: Not only do they ensure that Roma patients receive compassionate, dignified care from doctors who understand their unique challenges, but they also demonstrate talent and leadership, redefining the narrative of what it means to be Roma in Europe. For many of the students, the program is the only opportunity they would have to pursue their dreams of a career in medicine. “Even if I could afford it there are no teachers in my town to prepare me,” said Gabriela Tsotsarova, who commutes nine hours from her hometown on the Black Sea to Sofia. Some of the first graduates are now practicing professionals.  Angelov, for example, now mentors younger Roma students and believes the program serves as a practical model for Roma integration. “This program proves that when given the opportunity, Roma children can succeed,” he said.   DOCTORS WITHOUT PREJUDICE Discrimination, however, is still a challenge.  Despite TSA’s successes, institutional support for the program remains minimal. “The state does not recognize these students as individuals with the potential to contribute to society,” said Aylin Dzhafer, a project manager for TSA. “At the moment they are an untapped resource for the health sector.” Besides tutoring in biology and chemistry, the program teaches Roma history, financial literacy, mental health awareness and soft skills — a curriculum designed to prepare the students for the challenges they will face during their studies and careers. “Mentors offer students and future medical professionals support and guidance in an environment which is often hostile towards them,” Dzhafer said.  By pursuing higher education and entering fields like medicine, these young people are not only fulfilling personal dreams but also breaking down stereotypes that have long cast the Roma as a marginalized community. Despite TSA’s successes, institutional support for the program remains minimal. | Hristo Rusev/Getty Images “When patients come for a check-up, they don’t see me as a Roma man,” said Angelov. “They see me as the doctor who is there to help them.”   For the next generation of students, the stakes are high.  “I dream of a time when a Roma person graduating from university is no longer news, but the norm,” said Nikol Angelova, a young Roma student from the small town of Lom on the Danube River who started her medical degree in September following the completion of the prep course.  “I want to go back to Lom and continue working with the Roma community there,” she said. “One shouldn’t forget where you came from.”  This article is part of the Breaking out: Stories of Roma empowerment special report, presented by the Roma Foundation for Europe. The article is produced with full editorial independence by POLITICO reporters and editors. Learn more about editorial content presented by outside advertisers.

This is an exciting time in health innovation. Yes, we face real challenges in meeting demand for care, due to factors such as an aging population, shortages of healthcare professionals and the rise of non-communicable diseases. But we also see potential for several fields of technology to combine in ways that benefit patients. Healthcare is changing and Europe can be at the heart of this transformation. One patent every 30 minutes. This is how fast the medical technology sector advances. Devices, diagnostics, data and digital health: the power of medical technology has the potential to redefine how healthcare is delivered. Existing solutions – not all yet available in Europe – and the upcoming medical innovations can empower Europe to improve and save lives. They can also put health systems on a more sustainable path forward. > One patient every 30 minutes. This is how fast the medical technology sector > advances. That’s the power of medical technologies. For patients, this translates into better outcomes. Consider how remote monitoring keeps people feeling safe even a hospital distance; how advances in surgery accelerate recovery; how timely diagnosis facilitates prompt treatment that increases not only survival rates, but also quality of life.   With the benefit of long-established medical solutions and exciting innovations on the horizon, medical technologies can offer solutions for patients, healthcare professionals and healthcare systems. By supporting the development and launch of more medical technology here in Europe, people can look forward to swift and more equitable access to cutting-edge health technologies. via MedTech Europe The medical technology industry is one of Europe’s most innovative sectors, adding value to people’s lives and health systems, while creating jobs and driving exports. Europe’s 37,000 medical technology companies – 90% of which are small and medium-sized enterprises – invest heavily in innovation and employ more than 880,000 people. For context, that’s on par with the population of Zagreb. These companies deliver a range of everyday solutions such as sticking plasters, syringes and surgical masks, as well as advanced technologies that include genetic tests, implantable heart valves and pacemakers, as well as a wide array of digital health solutions. Many patients receiving healthcare, whether at home, in the community or in a hospital, are likely to encounter several medical technologies on their journey.  In fact, the chances are that you and your family have benefited from some of these products. Sometimes, we use these tools without giving a second thought to how they were developed. Or our doctors, nurses and pharmacists harness their power to improve our care in ways we do not see – in the lab, for example, or in the operating room. > The medical technology industry is one of Europe’s most innovative sectors, > adding value to people’s lives and health systems, while creating jobs and > driving exports. The power of medical technology stems from the millions of ways, big and small, that people across Europe encounter medical technologies. It is about the power of movement, the power of data, the power of protection, the power of independence and the ways this power brings efficiency to our valued health systems. via MedTech Europe Health is also the answer to boosting Europe’s competitiveness Boosting Europe’s competitiveness is on everyone’s lips. Let’s remember that, beyond delivering immense social benefits, better health promotes economic growth by boosting productivity. Health as an investment in economic growth should also be part of the current political discussion as a way forward. > Let’s remember that, beyond delivering immense social benefits, better health > promotes economic growth by boosting productivity.  Innovation continues to be critical to tackling diseases without a known cure, as well as to help us increase uptake and adherence to interventions that deliver positive patient outcomes. Health is part of the answer to boost Europe’s competitiveness. Europe now has five years to put patients at the heart of the conversation and harness new waves of technology to deliver a bright and healthier future – a future where our health systems can meet the immediate and long-term needs of the population in a way that is resilient to future shocks over the long term.  We have an unprecedented opportunity to build better, safer, more sustainable health services. Let’s take it together.  -------------------------------------------------------------------------------- Looking for more inspiration? Check out the #PowerOfMedtech Discover MedTech Europe’s manifesto Empowering Patients, Inspiring Innovation --------------------------------------------------------------------------------