The U.S. Trade Representative has launched a Section 301 investigation into Germany’s drug pricing policies, arguing the country leaves the U.S. with a disproportionate burden of global R&D costs. The probe, led by USTR ambassador Jamieson Greer, follows concerns that Germany is fast-tracking legislation that would further reduce spending on innovative pharmaceuticals. The investigation centers on whether Germany’s actions constitute unfair trade practices that impact the U.S. The USTR says public hearings are expected on Sept. 22 and that, if the findings support the U.S. case, Washington could pursue remedies such as confidential supplemental discounts or mandatory variable rate rebates. Germany’s planned healthcare savings measure—framed as a response to worsening deficits among state insurers—has drawn pushback from major drugmakers, including Eli Lilly and Boehringer Ingelheim, which reportedly canceled certain German production investment plans amid the reform push. Separately, a report from No Patient Left Behind argues that drug value assessments used in countries such as Canada and Germany undervalue innovative medicines by roughly 90%, calling the resulting HTA thresholds “outdated” and insufficiently capturing broader societal benefits.