President Trump is right to call out foreign countries for freeloading off American medical innovation. However, the push by some politicians, like Senator Bernie Sanders of Vermont, to adopt a Most Favored Nation (MFN) drug pricing model would do nothing to solve the problem—in fact, it would make it worse. Instead of ending foreign freeloading and holding other countries accountable, MFN would import the same socialist-style price controls that cripple foreign health care systems, giving our global competitors an even greater advantage while American patients, and especially seniors, pay the price.
Patients in countries with government-run health care systems often face rationed access to innovative treatments because drugmakers are forced to accept artificially low prices. Thankfully, the U.S. has long rejected that approach. Implementing MFN would reverse this precedent by tying U.S. drug prices to those of foreign countries, threatening seniors' access to lifesaving medications as they would begin to face the same restrictions that price controls have wrought on those abroad.
The damage in the U.S. would be widespread. When this model was proposed in 2020, the Centers for Medicare and Medicaid Services (CMS) projected that as much as 19% of drugs could become inaccessible as manufacturers face the untenable requirement to sell their products below their market price. For vulnerable seniors on Medicare, therapies for cancer and other chronic conditions can mean the difference between life and death.
MFN would also give a competitive edge to our global competitors, particularly China, which recently has outpaced the U.S. in drug clinical trials. Furthermore, a bipartisan commission recently warned Congress about the need for substantial national investments in biotechnology over the next five years in order for America to stay competitive with China. Adopting MFN – socialism in disguise – would only undermine incentives for high-risk, high-cost drug development. A more effective approach would follow President Trump’s extremely successful NATO model, pushing other wealthy nations to pay their fair share by ensuring they contribute the same share of GDP per capita on innovative medicines that we do.
Unsurprisingly, some groups, like the AARP, have come out in favor of MFN proposals. There’s no doubt that’s because it aligns with the organization’s faithful support of government price controls. AARP spent more than $60 million in advertising on the passage of the Biden-era Inflation Reduction Act, which gave big insurer-PBMs a financial windfall, raided roughly $260 billion from Medicare, and caused premiums and out-of-pocket costs to skyrocket. Coincidentally, the so-called “senior advocacy” group earns more than $1 billion in corporate royalties annually, primarily from UnitedHealth, the nation’s largest health insurer-PBM.
You can’t help but wonder… Is AARP supporting policies based on what seniors need or in the interest of their bottom line?
Seniors need a real plan to lower health care costs without sacrificing innovation, and President Trump has proposed a different framework to address this problem. One measure cracks down on the opaque practices of PBM middlemen who inflate drug prices and pocket discounts meant for seniors. Another proposal eliminates the Biden Pill Penalty, which discourages investment in small-molecule, easy-to-use drugs. These proposals would help resolve the inefficiencies in our health care system, while MFN would do the opposite.
Taking it a step further, cutting out the middleman entirely through direct-to-patient (DTP) sales would allow savings and rebates to be passed directly to seniors and prevent PBMs from steering patients toward their own pharmacies for profit. Implementing DTP would immediately inject much-needed transparency and affordability into America’s health care system.
The Biden administration’s policies, particularly the IRA, made the U.S. a hostile place for innovation, and President Trump is working hard to reverse the damage. But implementing MFN would undermine America’s free-market values, jeopardize our leadership in medical innovation, and put seniors’ access to lifesaving medications at risk—all while letting foreign countries continue to freeload off U.S. innovation.
Instead of embracing the socialist price controls embedded in MFN, President Trump should stay the course on his America First approach, which includes shifting to a direct-to-patient sales model, strong trade negotiations to make other countries pay their fair share, reining in insurer-PBM middlemen, and rolling back the IRA’s damaging price controls. America’s seniors and our future as the global leader in health care depend on it.
