When my mother died of colon cancer, I saw firsthand the devastation that comes when treatment options run out. For decades, I’ve worked to spare others that same fate — helping patients around the world get the right medicine at the right time.
That’s why I’m deeply concerned by President Donald Trump’s push to tie U.S. drug prices to those set by foreign governments.
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The concern isn’t the goal itself. Trump is right that other wealthy nations have long benefited from American pharmaceutical innovation without paying their fair share for it.
TRUMP’S ‘MOST FAVORED NATION’ DRUG PRICING PUSH RISKS UNDERMINING PRO-LIFE LEGACY
Bringing a new drug to market is enormously resource-intensive, requiring an average investment of nearly $2.7 billion. Yet governments in Europe, Japan, and elsewhere routinely impose arbitrary price controls on medicines, paying a fraction of what Americans do. Foreign governments achieve these lower prices by delaying access and devaluing medicines in ways that Americans roundly reject. As a result, patients around the world lack access to treatments — and the returns that sustain global pharmaceutical research and development depend disproportionately on the U.S. market.
The president wants to correct that imbalance. Unfortunately, his administration’s proposed solution — a “most favored nation” policy, or MFN — would move the United States in exactly the wrong direction. Rather than forcing foreign governments to contribute more to innovation, MFN would effectively import their price controls by pegging U.S. drug prices to the lowest prices abroad.
As a patient advocate, I’ve seen how other countries lower drug prices: by delaying and sometimes outright denying access to lifesaving therapies.
Consider Japan. Few countries bear a heavier burden from colorectal cancer. Yet Japan’s system of mandatory, across-the-board price cuts — reducing reimbursement on a fixed annual schedule regardless of a drug’s clinical value — has severely constrained patient access. In recent years, Japanese patients gained access to just 43% of newly launched medicines worldwide, compared to more than 80% for Americans. Every treatment a patient cannot access represents years of health, independence, and time with loved ones lost.
Europe tells a similar story. The United Kingdom, France, Italy, and other countries rely on standardized “health technology assessments” to determine how much they will pay for new medicines. These assessments routinely undervalue cutting-edge therapies — particularly for older adults and people with chronic illnesses, whose lower baseline health often makes treatment appear less “cost-effective.”
The result is predictable. In a study of 19 other high-income counties, patients have access to just 36% of the newest medicines — while Americans have access to 88% of them.
MFN would bring those same barriers to American patients. Millions could find themselves relying on older, less effective treatments. And because foreign pricing systems often undervalue therapies for chronic disease, patients who depend on continuous innovation would likely suffer the most.
By tying U.S. prices to artificially lower foreign prices, MFN would also drain the returns that fund breakthrough R&D. A University of Chicago analysis estimated that MFN-style controls could cut U.S. research spending in half — resulting in roughly 500 fewer new medicines over the next decade.
The consequences of stifled innovation would be felt by patients in the United States — and by patients across the globe, as the United States is the primary engine of medical progress.
The damage would not stop at America’s borders.
None of this means American patients should have to subsidize the rest of the developed world. But the solution isn’t to drag U.S. drug valuations down to foreign levels. It’s to push wealthy countries to contribute more fairly to the innovation ecosystem that patients everywhere rely on.
Fortunately, the administration has a better way to do exactly that.
A Section 301 investigation into foreign governments’ unfair pharmaceutical pricing practices would give the United States meaningful leverage to pressure other wealthy nations to stop freeloading off American innovation. The credible threat of trade consequences could force long-overdue reforms in countries that systematically undervalue new medicines.
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Because the greatest threat to patients is not high drug prices alone. It is a world in which the lifesaving medicines they are counting on are never developed — or never reach them at all.
MFN would move us closer to that world. And patients everywhere would pay the price.
Andrew Spiegel Esq., is the Executive Director of the Global Colon Cancer Association.
