A new report from No Patient Left Behind (NPLB) accused non-U.S. health technology assessment (HTA) systems—especially in Canada and Germany—of undervaluing innovative medicines by as much as 90%. NPLB said the methodology can distort coverage decisions and mislead U.S. policymakers by painting a “broken” market when, in its view, the system is what funds biopharma innovation. The group pointed to willingness-to-pay thresholds and quality-adjusted life year (QALY)-based frameworks as being out of date and failing to capture benefits beyond individual patients, including downstream societal returns such as faster return to work and reduced disability allowances. It also argued that HTAs do not adequately consider factors like ease of administration that can affect adherence and healthcare utilization. The report’s critique lands as policymakers debate pricing convergence tools in the U.S. and as European pharma advocates push for higher drug prices to support innovation. NPLB framed its conclusions as a bargaining and access issue tied to how coverage disputes are resolved across jurisdictions.