The Most Favored Nation Mandate: What the President’s Drug Pricing Push Means for the Pharmaceutical Industry, Payers, and Patients

On September 10, 2025, a panel of industry leaders gathered virtually to unpack the potential impacts of the administration’s actions relating to Most Favored Nation (MFN) drug pricing. Moderated by Ned Milenkovich, PharmD, JD, chair of the health care practice at Much Shelist, PC, the discussion featured insights from Brian Corvino; Neal Masia, PhD; Ali Pashazadeh, MD; and George Van Antwerp, MBA, about what MFN could mean for pharmaceutical companies, payers, and patients.

In recent months, the Trump administration has taken several executive actions aimed at bringing US prices for prescription drugs in line with those of similarly developed countries. These include an executive order issued on May 12, 2025, Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients and letters to leading pharmaceutical manufacturers outlining steps they should take to bring US drug pricing in line with the lowest price offered in other developed countries. On September 25, 2025, the Administration posted a notice referring to a “global benchmark for efficient drug pricing (GLOBE) model” under the Department of Health and Human Services. While the notice did not contain details, it may signal upcoming regulatory action relating to prescription drug pricing following an MFN model. 

A Shifting Landscape

Corvino, principal and global market access practice leader at Deloitte US, framed MFN in a historical context, noting its long use in US trade policy and its recent reemergence through executive orders. This groundwork, he added, sets the stage for substantial change in the drug pricing environment, building on the trajectory set by the Inflation Reduction Act.

Masia, cofounder and chief executive officer of EntityRisk, Inc, added that while the concept isn’t new—Europe has long used reference pricing—government-imposed drug pricing limitations would represent a turning point in US prescription drug pricing policy. “The underlying goal is clear: lowering drug prices,” he said. At the same time, Masia conceded that the policy has created uncertainty that may push biopharmaceutical companies to scale back European investments.

Who Stands to Gain?

Panelists agreed that patients should be the ultimate beneficiaries of lower drug prices, but they emphasized that the complexity of the US supply chain poses challenges. Van Antwerp, senior vice president of product innovation and strategic planning at Prime Therapeutics, underscored that affordability is urgent: “One-third of the public is skipping doses because they can’t afford medication.” Still, he cautioned against creating even more complications in an already tangled system.

Dr. Pashazadeh, founder, chairman, and chief executive officer of Treehill Partners, emphasized the human impact: “The only person I care about here is the patient. Everyone else is a bystander.” He stressed that policymakers must remember that behind every pricing model is someone’s mother, father, or child.

Industry Response

How will the pharmaceutical industry react? According to Masia, direct-to-consumer models may be one of the industry’s favored paths forward, citing Eli Lilly’s success as an early example. Companies may also need to better articulate the value of their therapies in a crowded market.

Covino described the industry as “caught in purgatory”—torn between taking immediate action to prepare for change or adopting a wait-and-see approach until policy details are finalized. Dr. Pashazadeh warned that missteps could set companies back a decade, citing AstraZeneca’s withdrawal from France as a cautionary tale. 

Implications for R&D 

Innovation emerged as one of the central concerns. Drug development already faces staggering failure rates: only 5% of phase 1 candidates and half of phase 3 candidates reach the market. Panelists noted that pricing power is already constrained by negotiations and market pressures. Still, Corvino highlighted a troubling 15% decline in drug launches post–COVID 19, suggesting that new policies may add more complexity to already strained research and development (R&D) pipelines. He added, “It does affect investment decisions; today’s current sales fund future R&D investments.” 

Looking Ahead 

For patients, the ultimate question is whether MFN policy will lower out-of-pocket costs and improve access. “We haven’t seen anything that will address out-of-pocket patient costs,” Corvino acknowledged during the Q&A session. Meanwhile, panelists pointed to grassroots advocacy and patient-centered policymaking as critical to ensuring that reforms deliver meaningful benefits. 

Van Antwerp concluded: “Is it saving money? Is it simplifying health care?” Until those questions are answered, the MFN mandate may be less a solution than a catalyst, forcing stakeholders to the table and sparking further conversations about how to balance affordability, access, and innovation in US health care. “If the goal is to not undermine R&D and to make it better for patients and those using the drugs, I think MFN can bring the industry to the table. But the solution may be something different; it may take a while for the right model to come together,” Masia summarized.

This webinar series is produced by MJH Life Sciences® in collaboration with The American Journal of Managed Care®, Chief Healthcare Executive®, Drug Topics®, HCPLive®, Managed Healthcare Executive®, Medical Economics®, OncLive®, Pharmaceutical Commerce®, Pharmaceutical Executive®, and Pharmacy Times®.