Pharmacy Industry Leaders Gather to Discuss Most Favored Nation Drug Policy

The Most Favored Nation drug policy, often shortened to MFN, is an executive order that requires drug manufacturers to sell drugs at a price no higher than the lowest price offered for that specific drug across various developed countries. While the core functions of this policy may be ideal for patients and their access to prescription drugs, experts are significantly uncertain as to how the MFN policy will actually be implemented.

“This past May, there were 2 executive orders introducing, or I should say reintroducing, the topic of MFN for drug pricing,” Brian Corvino, principal and global market access practice leader at Deloitte Consulting, said during the roundtable. “There was a first executive order that introduced some direction related to MFN and introduced the concept of direct-to-consumer. A following subsequent executive order [allocated or focused] on [brand-name drugs], as well as defining markets that might be in a comparable position for that.”

While the public’s current understanding lies within provisions under President Trump’s May 12 executive order, the MFN policy and its ideas were drafted during his first term as president. With the first push toward the MFN policy being shot down toward the end of 2020, Trump has recently reintroduced the topic, as Corvino mentioned, leading industry experts and business leaders into a frenzy and forcing them to streamline their collective understanding of how the policy will be implemented.¹

In the roundtable discussion, 4 speakers led the conversation and explored the potential winners and losers of the MFN policy, its legal challenges, and so much more. | image credit: KM / stock.adobe.com

In the roundtable discussion, 4 speakers led the conversation and explored the potential winners and losers of the MFN policy, legal challenges, industry pricing strategies, the policy’s impact on research and development, patient access implications, and so much more.

“There are rules like this in Europe that govern reference pricing between those countries and have been in place for decades now, and they have pretty predictable effects. But you're sort of put in a position as an economist of trying to bring a bunch of logic and facts to a debate that is not really about that,” said Neal Masia, PhD, co-founder and CEO of EntityRisk. “I think this is the administration saying to itself, what's the worst imaginable thing I think I can do within the bounds of my authority to the industry to get them to the table so that they will announce and change some behaviors?”

Along with Corvino and Masia, this 3-part roundtable discussion featured the likes of Ali Pashazadeh, founder, chairman, and CEO of Treehill Partners, as well as George Van Antwerp, MBA, senior vice president at Prime Therapeutics. The conversation was moderated by Ned Milenkovich, PharmD, JD, chair of the health care practice Much Shelist, PC.

The discussion began with detailing the MFN state of play, exploring what the panel experts believe the administration is trying to achieve with its industry-shaking executive order. They gave their thoughts, harping on the complexities and uncertainties surrounding the newly formed policy. The experts then delved into the various entities that would be impacted by this policy if and when its requirements are implemented.

One key aspect is how drug companies will react regarding their direct-to-consumer models.

“I think their favorite response that I think will happen faster than it otherwise would have, is this whole direct-to-consumer model,” Masia concluded. “I think that [with] the pressure there, [it’s] hard to see that in 5 or 10 years, there won't be a lot more direct selling to consumers. I think that the intermediary model of negotiating the discounts will have to kind of catch up to that model, because otherwise they'll be in trouble.”

From research and development to market distribution and payer pricing to overall access for patients, the experts detailed all avenues of where the MFN policy will reach various stakeholders in the marketplace.

First, regarding research and development (R&D), the uncertainties behind how manufacturers create net and list prices may be even further skewed after implementation of the MFN policy. With so many checks and balances for a drug’s price throughout R&D and pharmacy benefit managers (PBMs) managing drug benefits, there has historically been significant uncertainty about what the true price of a drug should be.

Instances like these, as well as the increasing demand to improve patient access to prescription drugs, highlight the Trump Administration’s devotion to lowering prescription drug prices. While there are still several steps needed to implement this policy, experts like Corvino, Masia, Van Antwerp, and Pashazadeh are asking the pertinent questions in the meantime.

“When any idea comes through, we look at it [like], is it saving money, saving the patient money out of pocket, [or] saving the client money?” Van Antwerp concluded. “Is it simplifying health care or not, from the outside in, not from the inside out? What helps the consumer? Is it making it easier for them to navigate this overly complex health care system? I would encourage, as we think about all this reform, that we simplify it down to those types of things.”

To see the full video of the MFN drug policy roundtable, visit here.

REFERENCE

1. Rogers HA. Most-favored-nation prescription drug pricing executive order: legal issues. Library of Congress. June 5, 2025. Accessed September 11, 2025. https://www.congress.gov/crs-product/LSB11319