Mike Hollan

President Trump’s executive order pushing for most-favored-nation (MFN) pricing for pharmaceuticals sent shockwaves through the industry. While most people agree that healthcare and pharmaceuticals are often prohibitively expensive and patients are often unable to afford the treatments they need, forcing drug prices down in the US can have other consequences.

 held the first in a series of executive webinars on Wednesday, Sept. 10, 2025, bringing together industry experts to discuss the potential impact of MFN on pharma and how the industry can strategize ahead of its implementation. Hosted by Ned Milenkovich, head of health care practice at Much Shelist and editorial advisor for 

Brian Corvino: principal and global market access practice leader with Deloitte

Neal Masia, PhD: co-founder and CEO at EntityRisk, Inc.

Ali Pashazadeh: founder, chairman, and CEO at Treehill Partners

George Van Antwerp, MBA; senior vice president of product innovation and strategic planning at Prime Therapeutics

The discussion began with Corvino laying the groundwork for the current landscape. As he explained, “There’s a long history of the concept of MFN in US trade policy. That being said, that issue has become very active in drug pricing in the last year. Earlier this year, two executive orders reintroduced the topic of MFN for drug pricing.”

He continued, “The current administration continues to lay the groundwork for the drug pricing environment, specifically in the US. There’s important connectivity with this and the Inflation Reduction Act (IRA) and whether some of guidance or direct negotiations, 340B drug price transparency, ASP calculation, and not to mention tax trade and tariff policy.”

Masia chimed in, “I think this is the administration saying what’s the worst imaginable thing I can do within the bounds of my authority that I can do to the industry to get them to the table so that they will announce and change some behaviors. The specifics of MFN may mostly be unworkable, but the underlying goal is clear: announcements about lower drug prices in some way.”

When asked who stands to gain and who stands to lose from the MFN order, Pashazadeh answered, “The only person I care about here is the patient. Everybody else is a bystander or observer in this conversation. Having graduated 30 years ago and lived through MFN in Europe, the result is that Europe is optimizing for the 95

 percentile (for every 100 patients that come in, we’re treating 95 in the most cost effective manner). What happens to the remaining patients? They do matter. The number of times I’m in a hospital and a patient needs a treatment but the hospital administrator is saying that it’s not cost effective…”

“My view is,” he continued, “we've got legislature, lawyers, and everyone else who is going to negotiate this and put frameworks in place. They must keep in mind at the end of the day there is someone's mother, father, or child who is going to pay the price.

How will pharma respond, and how will that response play out?

The conversation then turned to the topic of pharma’s response, with Van Antwerp explaining, “During the last Trump administration, there were multiple legal challenges from the industry. I’m sure we will see similar things play out here. In a perfect world, the pharma companies would just lower the prices and say that they don’t want to deal with the complexity of the system. They would show the administration that they can lower list prices and that they’re willing to be flexible.”

“The challenge is that 80% of the profits are coming from the US, it is the largest global market,” he continued. “Most companies would struggle to not be in the US long term. When it comes to innovation, it doesn’t require unchecked pricing to be allowed in order to exist.”

Does MFN and other pricing policies pursued by the administration put biopharma innovation and the US’ position as the first-to-launch territory in jeopardy?

Masia replied to Van Antwerp’s comments, saying, “If pricing was really unchecked, then PBMs wouldn’t exist. Their entire business is to check the pricing power, which is why there is such a big gap between the list and net prices. This is likely why people like Donald Trump are annoyed, because it’s such a confusing mess and nobody really knows what the price of a drug really is.”

Moving on to the topic of innovation, he said, “If you're thinking about MFN to say that the world is paying less, why can’t the US pay less, the answer that everybody is circling is that the US market is not what’s going to most affected in the near term. It’s the other markets where drugs do get launched in because the price bleeds through the whole system. In the US, from an R&D perspective, you would be picking and choosing the areas where the value is the clearest and everyone understands why this is a valuable innovation.”

The conversation then moved to closing thoughts, with Corvino summarizing his thoughts as, “This is a time where bringing ideas to the table is an absolute necessity. There’s a lot of ways to do that, so I encourage real activation and being part of shaping that policy. There’s been quite a bit of innovation that’s being discussed in terms of new models, and it’s time to thinking about bringing those models to the marketplace.”

Van Antwerp continued, “When any idea comes through, we look at it across three basic ways:

Is it saving the patient money out of pocket

Articles

President Trump's executive order on most-favored-nation (MFN) pricing for pharmaceuticals has sparked significant debate within the industry. Experts discussed the potential impacts of MFN on drug pricing, patient access, and pharmaceutical innovation. The order aims to lower drug prices, but its feasibility and implications for the US market and global innovation remain contentious. Industry responses may include legal challenges and strategic pricing adjustments. The discussion emphasized the need for innovative policy solutions that balance cost-effectiveness with patient access and the sustainability of pharmaceutical innovation.

Key points from our recent webinar on the President’s MFN order.

What the President’s Drug Pricing Push Means for Pharma, Payers, and Patients

On Sunday, President Trump posted to Truth Social that he planned on implementing a most-favored-nation policy for pharmaceutical drug prices.

On the social media site, President Trump wrote, “For many years the World has wondered why Prescription Drugs and Pharmaceuticals in the United States States of America were so much higher in price than they were in any other nation, sometimes being to ten more expensive than the same drug, manufactured in the exact same laboratory or plant, by the same company?”

(Please note that the President’s post has been edited to remove capitalized words. The rest of the text remains as originally written.)

He continued, “It was always difficult to explain and very embarrassing because, in fact, there was no correct or rightful answer. The Pharmaceutical/Drug Companies would say, for years, that it was Research and Development Costs, and that all of these costs were, and would be, for no reason whatsoever, borne by the ‘suckers’ of America, alone. Campaign Contributions can do wonders, but not with me, and not with the Republican Party.”

A most-favored-nation clause states that a certain party is given treatment equal to or better than any other party.

Trump continued, stating that he plans on signing an executive order on Monday morning (May 12) at 9 am Est that reduces pharmaceutical drug prices. According to his post, the order will impact drug prices by 30-80%.

It’s unclear how broadly Trump plans to extend the impact of the executive order. The government is set to negotiate Medicare prices, but the wording of Trump’s post does not make this specification. Additionally, Trump also states that drug prices may increase in other parts of the world to make them “fair” with American prices.

Technically, pharma companies could simply increase prices in other nations in order to honor a most-favored-nation clause with the United States. However, this would go against Trump’s pledge to reduce the cost for Americans.

It’s unclear if this is a move that the President can enforce via executive order. However, the Republican controlled House and Senate have generally supported President Trump’s efforts.

The President’s Truth Social post concludes, “I will be instituting a most-favored-nation’s policy whereby the United States will pay the same price as the Nation that pays the lowest price anywhere in the world. Our Country will finally be treated fairly, and our citizens Healthcare Costs will be reduced by numbers never even thought of before. Additionally, on top of everything else, the United States will save trillions of dollars.”

President Trump has also said that he plans to institute tariffs on pharmaceuticals by mid-May.

 It’s unclear how this latest announcement will impact the tariffs. Tariffs would likely impact the prices of pharmaceuticals. However, if pharma companies are forced to reduce prices in the United States, it’s unclear how they would be able to keep prices low in the face of tariffs.

. May 11, 2025. https://truthsocial.com/@realDonaldTrump/posts/114491534347862682

Charter, David. Trump to announce pharmaceutical tariffs ‘in next two weeks.’ 

. May 6, 2025. https://www.thetimes.com/us/news-today/article/trump-announce-pharmaceutical-tariffs-two-weeks-7fxlr2r58

The President plans to sign an executive order on Monday morning to enforce the trade clause.

President Trump Announces Most-Favored-Nation Policy for Pharma Prices

The businessman’s pharmaceutical company, Cost Plus Drugs, is partnering with Price.com to build a platform where consumers can compare drug prices. According to a press release from Price.com,

 the goal of the platform is to make prescription drugs more affordable to the people who need them. By being able to compare drug prices, users will be able to find the most affordable sources.

In a press release, Mark Cuban Cost Plus Drug Company CEO Alex Oshmyansky said, “We are thrilled to collaborate with Price.com in our mission to make prescription drugs more affordable for consumers. At Cost Plus Drugs, our commitment to transparent drug pricing has always been unwavering, and with Price.com, we are dedicated to providing affordable and accessible healthcare solutions for all."

In the same press release, Price.com CEO and founder RJ Jain also said, “Teaming up with Mark Cuban Cost Plus Drug Company is a pivotal step towards achieving our shared goal of improving healthcare affordability and accessibility. Thanks to this collaboration, Price.com users can make informed choices that best suit their health and financial needs."

This is just the latest move Cuban’s company has made towards increasing its prominence in the pharmaceutical landscape.

In mid-March, Cost Plus Drug Company announced that it had teamed up with Provell Pharmaceuticals to provide patients with direct access to Euthyrox, a leading hypothyroid drug.

 The goal of this partnership is— similarly to the company’s partnership with Price.com—to provide the drug at affordable prices.

According to a press release from Provell Pharmaceuticals, Euthyrox is one of the most prescribed drugs worldwide.

In the press release, Provell Pharmaceuticals CEO Steve Hodge said, “Our mission is to remove the cost barrier for millions of Americans, regardless of insurance coverage, who need quality medications but who often cannot afford them due to markups imposed by a variety of players in the US healthcare landscape. By working directly with online platforms such as Cost Plus Drugs, which shares our vision to make drugs affordable and accessible to all, we are disrupting the traditional model and conferring significant savings to patients."

In the same press release, Oshmyansky added, “Drug prices continue to rise exponentially, and it's an unsustainable trend that is extracting a huge toll on the health and well-being of many Americans. We've developed an alternative model–and are partnering with like-minded companies such as Provell Pharmaceuticals—to offer prescription drugs directly to consumers at a fraction of the cost by showing consumers exactly what the drugs cost, exactly what our margin is, and exactly what consumers will pay. It's fair, transparent, and is dramatically less expensive for patients."

Price.com Announces Collaboration with Mark Cuban Cost Plus Drug Company to Make Prescription Drugs More Affordable. 

https://www.prnewswire.com/news-releases/pricecom-announces-collaboration-with-mark-cuban-cost-plus-drug-company-to-make-prescription-drugs-more-affordable-302105807.html

Provell Pharmaceuticals and Mark Cuban Cost Plus Drug Company Bring Leading Hypothyroid Drug, Euthyrox®, to U.S. Patients at Low-Cost Prices through Direct-to-Consumer Model. 

. March 12, 2024. Accessed April 2, 2024. 

https://www.prnewswire.com/news-releases/provell-pharmaceuticals-and-mark-cuban-cost-plus-drug-company-bring-leading-hypothyroid-drug-euthyrox-to-us-patients-at-low-cost-prices-through-direct-to-consumer-model-302085598.html

The two company’s will provide consumers with a platform where they can compare drug prices.

Mark Cuban’s Cost Plus Drugs Partners with Price.com

Novo Nordisk’s parent company recently announced that it has agreed to purchase Catalent. As part of the acquisition, Novo Nordisk will purchase three of Catalent’s manufacturing sites. This is part of a move by the company to increase its ability to meet the demand for Wegovy, a highly popular weight loss drug.

Bruce Phelan, senior partner at Blue Fin, spoke with Pharmaceutical Executive about the larger impact that this purchase will have on the industry. The pharma industry has seen a return of mergers and acquisitions in the past year, and Phelan discusses how this trend may continue.

Pharmaceutical Executive: Will other pharmaceutical companies need to start buying CDMO/CMOs to ensure they have the capacity they need?


The pharmaceutical manufacturing market has been undergoing significant growth since 2015 and is divided between CDMOs (contract development and manufacturing organizations) and CMOs (contract manufacturing organizations). There has been a significant shift of pharmaceutical manufacturers core competencies, especially in manufacturing expertise and increased sophistication of complex products, and an increased reliance on CDMOs and CMOs for capacity and expertise, inclusive of API manufacturing as well as Finished Goods manufacturing.

As such, small and large pharmaceutical companies have increased their outsourcing to their drug manufacturing CDMO or CMOs partners because they need access to manufacturing capacity or technological manufacturing capabilities beyond what they have within their in-house manufacturing capabilities and capacities and to mitigate potential risk of under supply or low yield.

The global need for manufacturing capacity and technical expertise has significantly accelerated over the past 7-8 years and furthermore during the pandemic. The advent of mRNA, increased vaccine production, precision medicine, CGTs and radio-pharmaceuticals manufacturing has absorbed a lot of the sophisticated CDMO and CMO available manufacturing capacity, making more complex manufacturing more valuable and less available. These product-level demands require CDMO and CMO manufacturing line dedication, personnel expertise, technology transfer, and specific manufacturing understanding to operate CDMOs and CMOs.

Purchasing and vertically integrating a CDMO or CMO into pharmaceutical manufacturers supply chain is worth considering dependent upon the need for increased/excess supply of the Finished Goods (product), specific manufacturing requirements, the need for excess or increased capacity based on commercial product forecasting, and to manage downside risks of the lack of outsourced manufacturing capacity or the trained personnel to operate sophisticated manufacturing processes.

For example, manufacturing delays and stock outs for key medicines have highlighted downsides of outsourcing to manufacturers with short-term, arm’s length partnership models. Buying a CDMO and/or CMO puts the control of manufacturing back into the hands of pharmaceutical manufacturers to ensure their own product supply.

The current independent CDMO/CMO markets continue to operate through expanded demand, limited capacity, and under a high degree of fluctuating uncertainty.

CDMO and CMO Market(s) lacks clarity on future capacity needed for pandemic-related projects—potential that vaccine will be needed on an annual basis, but is subsiding.

Demand for “traditional biopharma” capacity is volatile in the short-to-mid-term – depending on product demands for products and indication expansions for PD-1 / PD-L1 inhibitors, CGT, and vaccines (among others).

Shortage of capacity to satisfy current and future manufacturing needs of CGTs (sophisticated manufacturing techniques)–but bulk of pipeline is in pre-clinical phase and degree of progression to later stage trials is uncertain.

PE: Will pharmaceutical companies need to invest in building out their own facilities?


Creating external CDMO and CMO supply chains and manufacturing product supply may be a manufacturing scaling option and potential value driver for many established global pharmaceutical companies. However, scaling into additional CDMO and CMO manufacturing platforms to accomplish capacity and efficiency requires aligned business processes, software supporting manufacturing, digital systems, and interfaces with the parent pharmaceutical company, and detailed manufacturing analytics supporting capacity and capability.

In addition to the costs of building or acquiring the manufacturing physical plant, footprint, licensures, and construction; pharmaceutical companies are confronted with significant operational burden, digital integration, and managing manufacturing personnel outside of their current bandwidth and expertise.

Reasons to invest capital into building manufacturing facilities:

Multiple promising technologies entering market that require unique manufacturing capabilities.

mRNA therapy development is expected to expand rapidly post COVID and well into the future.

Precision Medicine, Personalized Medicine, and Cell and gene therapy is a major focus of development, but commercial timelines, demand, and impact is uncertain.

Increased pressure to manufacture within same country/region due to nationalist/regionalist interests.

PE: If you are a pharmaceutical company, will you want to do business with a CMO/CDMO that is beholden to a competitor?


Large CDMOs and CMOs support multiple small and large pharmaceutical companies’ products. For example, Lonza supports multiple and potentially competing products they manufacture for several pharmaceutical companies. Although companies and products compete for the same limited capacity, CDMOs and CMOs are not constrained by competitor products. Instead, the challenge is meeting the capacity requirements of current and future capacity requirements by multiple pharmaceutical companies vying for the same limited manufacturing sites and techniques. Not only are site and capacity limited placing high concentration on certain CDMOs and CMOs, so too are the technically trained personnel who operate pharmaceutical manufacturing sites. Ultimately, pharmaceutical manufacturers compete for manufacturing line space and capacity as well as the trained human capital it takes to manufacturer pharmaceutical API and Finished goods and the strategic capabilities to manage future capacity and growth trajectory.

PE: What does this mean for the weight loss/diabetes group of drugs from other companies like Lilly?


The unprecedented and significant increase in product demand for GLP-1 products for the treatment of diabetes and weight loss has surpassed the original contracts, production forecasts, and capacity for CDMOs and CMOs and particularly those that specialize in API manufacturing as well as biosimilar manufacturing.

The risk of market failure (where supply ≠ demand) in the short-to mid-term is real. Continued high demand for CMO capacity due to COVID-19, vaccines, and specialty products coupled with substantial demand volatility in other key areas, has increased the probability that CMOs may under commit to the necessary capacity expansions needed to sufficiently meet demand for traditional biopharma manufacturing, inclusive of diabetes, weight-loss, and GLP-1s.

CDMO/CMO shift to a sellers’ market suggests they may seek longer term, comprehensive partnerships with pharmaceutical manufacturer partners. The line between CDMO and CMO is getting smaller as development timelines are shortening and pharmaceutical product launches shift to smaller volume and highly specialized products that consume capacity and manufacturing expertise.

To leverage the benefits of a CDMO/CMO end-to-end manufacturing models, which may be required to support products such as a GLP-1 model, a manufacturer must involve commercial manufacturing network planning early on in the clinical development process. Without this early commercial integration, selection of a CDMO is only based on “D” capabilities, not “M” capabilities to try to support the excess demand.

Bruce Phelan of Blue Fin discusses Novo Nordisk's purchase of Catalent manufacturing sites to increase its ability to meet the demand for the popular weight loss drug Wegovy.