Governments compete to attract research, investment and high-value jobs while trying to contain healthcare spending and secure access to new medicines. 

These objectives do not always align. The United States offers large commercial opportunities, Europe combines scientific excellence with fragmented pricing and reimbursement, and China is rapidly expanding its role in drug development. 

At the same time, European countries compete among themselves for investment and talent, despite shared interests. Are European startups constrained mainly by capital, or by the markets in which their innovations must earn returns? 

This presentation by Prof Xander Koolman shows how national policies can create spillovers, distort investment and trigger subsidy races. It asks where national interests justify intervention, where international coordination could create more value, and how innovation policy can balance competitiveness with affordable healthcare and societal welfare.