Fact Sheet: President Donald J. Trump Announces First Deal to Bring Most-Favored-Nation Pricing to American Patients

9/30/2025

Fact Sheets

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Action Summary

MFN Pricing Agreement: President Trump announced an agreement with Pfizer to implement most-favored-nation (MFN) pricing for American patients, aligning U.S. drug prices with those paid by other developed nations.
Medicaid Savings: The deal will enable State Medicaid programs to access MFN prices on Pfizer products, leading to millions of dollars in savings for American healthcare.
Prevention of Global Free-Riding: The agreement prohibits foreign nations from using price controls to benefit from American pharmaceutical innovation by ensuring MFN pricing on all innovative Pfizer products.
Repatriation of Revenue: Pfizer is required to repatriate any increased foreign revenue from existing products, reinforcing the Administration’s America First trade policies.
Deep Discounts for Direct Purchases: Patients will benefit from significant discounts when purchasing directly, with key examples including:
- Eucrisa: 80% discount for atopic dermatitis treatment.
- Xeljanz: 40% discount for rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis.
- Zavzpret: 50% discount for migraine treatment.
Addressing Global Price Imbalances: The initiative targets the disparity where American patients pay significantly more than patients in other developed nations, countering the current system that subsidizes high U.S. prices to bolster profits abroad.
Policy Continuity: This action follows previous President Trump directives, including the May 12, 2025 Executive Order on MFN prescription drug pricing and subsequent communications with major pharmaceutical manufacturers.

Risks & Considerations

The Executive Order on Most-Favored-Nation (MFN) pricing could lead to significant changes in the pharmaceutical industry, impacting research funding and partnerships at Vanderbilt University. The focus on reducing drug prices may affect the financial dynamics of pharmaceutical companies, potentially influencing their investment in research and development.
Vanderbilt’s medical and health-related programs may need to adapt to changes in drug pricing and availability, which could affect clinical trials and research projects that rely on pharmaceutical partnerships.
The emphasis on reducing drug costs for American patients could lead to increased scrutiny of research funding sources and collaborations with pharmaceutical companies, necessitating a review of compliance and ethical standards.
There is a potential risk that the focus on American patients first could lead to reduced international collaboration opportunities, as pharmaceutical companies may prioritize domestic markets over global partnerships.

Impacted Programs

Vanderbilt University Medical Center may experience changes in drug procurement processes and pricing structures, affecting patient care and treatment options.
The School of Medicine could see shifts in research funding and collaboration opportunities with pharmaceutical companies, impacting ongoing and future research projects.
Vanderbilt’s Health Policy Center may have increased opportunities to study the effects of drug pricing policies on healthcare access and affordability, providing valuable insights for policymakers.
The Office of Research might need to reassess its strategies for securing funding and partnerships with pharmaceutical companies in light of the new pricing regulations.

Financial Impact

The reduction in drug prices could lead to decreased revenue for pharmaceutical companies, potentially affecting their ability to fund research initiatives and collaborations with academic institutions like Vanderbilt.
Vanderbilt University may need to explore alternative funding sources for research projects that previously relied on pharmaceutical partnerships, such as government grants or private foundations.
There could be opportunities for Vanderbilt to engage in policy research and advocacy related to drug pricing and healthcare access, potentially attracting new funding and collaboration opportunities.
The changes in drug pricing may also impact the financial planning and budgeting for healthcare services provided by Vanderbilt University Medical Center, necessitating adjustments to ensure continued patient care and service delivery.

Relevance Score: 4 (The order presents a need for potential major changes or transformations of programs.)

Key Actions

Vanderbilt University Medical Center (VUMC) should evaluate the impact of the Most-Favored-Nation pricing on its pharmaceutical procurement strategies. By understanding the cost savings from reduced drug prices, VUMC can optimize its budget allocation for patient care and research initiatives.
The Department of Health Policy should conduct research on the implications of the Most-Favored-Nation pricing policy on healthcare access and equity. This research can provide valuable insights into how these pricing changes affect patient outcomes and healthcare costs, positioning Vanderbilt as a thought leader in health policy analysis.
Vanderbilt’s Office of Federal Relations should engage with policymakers to advocate for continued support of pharmaceutical innovation while ensuring fair pricing for American patients. By participating in policy discussions, Vanderbilt can influence future healthcare policies that align with its mission and values.
The School of Medicine should explore partnerships with pharmaceutical companies to leverage the reduced drug prices for clinical trials and research. This could enhance Vanderbilt’s research capabilities and attract more funding opportunities.
Vanderbilt’s Center for Health Services Research should analyze the long-term effects of the Most-Favored-Nation pricing on healthcare delivery and patient satisfaction. Sharing these findings with the healthcare community can enhance Vanderbilt’s reputation as a leader in healthcare research and innovation.

Opportunities

The Most-Favored-Nation pricing presents an opportunity for Vanderbilt University to expand its research on cost-effective healthcare delivery models. By studying the impact of reduced drug prices on healthcare systems, Vanderbilt can contribute to the development of sustainable healthcare solutions.
Vanderbilt can capitalize on the focus on reducing drug prices by developing educational programs and workshops for healthcare professionals on cost management and patient care optimization. This could enhance Vanderbilt’s role in training the next generation of healthcare leaders.
The emphasis on fair drug pricing aligns with Vanderbilt’s commitment to social responsibility and healthcare equity. The university can develop outreach programs to educate the community about the benefits of the Most-Favored-Nation pricing and its impact on healthcare access.
By engaging with pharmaceutical companies and healthcare organizations, Vanderbilt can position itself as a leader in the national conversation on drug pricing reform. Hosting conferences and public forums on the implications of the Most-Favored-Nation pricing can further establish Vanderbilt as a hub for innovative healthcare thought and practice.

Relevance Score: 4 (The executive order presents the potential for major process changes required for Vanderbilt’s healthcare programs due to impacts on drug pricing and procurement strategies.)

Average Relevance Score: 3

Timeline for Implementation

N/A

No explicit deadlines or implementation timeframes are outlined in the directives. Based on the text, only signing and announcement dates are provided without specifying a compliance period.

Relevance Score: 1

Impacted Government Organizations

Centers for Medicare & Medicaid Services (CMS): CMS is critical as it administers State Medicaid programs that will directly apply the MFN drug pricing, ensuring that the discounted rates benefit a large population of American patients.
Department of Health and Human Services (HHS): HHS oversees the broader health policy and public health initiatives, including the implementation of cost-saving measures for prescription drugs for Americans.
Department of the Treasury: The Treasury is implicated in the requirement for Pfizer to repatriate increased foreign revenue, linking international earnings with domestic cost-saving policies.
Office of the United States Trade Representative (USTR): The USTR is relevant due to the MFN pricing strategy, which aims to rebalance trade relations and ensure that other nations cannot leverage price controls to benefit from American innovation.

Relevance Score: 2 (A moderate number of Federal Agencies and related entities are impacted by the directive.)

Responsible Officials

Department of Health and Human Services (HHS) – Charged with overseeing the implementation of the MFN pricing directive by ensuring that State Medicaid programs adopt the negotiated pricing terms.
State Medicaid Program Administrators – Responsible for executing adjustments to drug pricing at the state level in accordance with the Executive Order’s provisions.
Federal Pharmaceutical Negotiation Teams – Tasked with engaging directly with pharmaceutical manufacturers (e.g., Pfizer) to ensure compliance with the discount and revenue repatriation requirements.

Relevance Score: 4 (The directives affect agency heads and senior administrators responsible for enforcing the policy changes nationwide.)