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Trump breaks Big Pharma’s price wall
By Kerry McQuisten
Oct. 24, 2025
In October 10, AstraZeneca joined Pfizer in striking a landmark deal with the Trump administration to offer “most favored nation” (MFN) pricing for state Medicaid programs through the new TrumpRx.gov. MFN finally ends Big Pharma’s longstanding practice of overcharging Americans to offset the discounts they give foreign governments with socialist price-controlled systems.
For Americans without insurance, MFN could mean no longer paying up to 422% more for certain brand-name drugs than patients abroad.
These agreements with AstraZeneca and Pfizer follow the commitments President Trump made to lower drug prices in his May executive order, “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” and his April order, “Lowering Drug Prices to Once Again Put Americans First.” These agreements also represent a significant victory in a decades-long fight to lower drug prices and are sending ripples through corporate boardrooms.
For years, U.S. patients overpaid to fund pharmaceutical research while foreign countries received steep discounts. As Trump’s May E.O. notes, “the United States has less than five percent of the world’s population and yet funds around three quarters of global pharmaceutical profits.” A 2023 AARP report underscores the scope of the problem, finding that drug companies “consistently” raised prices above inflation on 943 top-selling drugs between 2006 and 2020 — a trend that continues, with more than 250 drugs seeing price hikes this year alone.
Instead of owning up to their role in driving up prescription costs, many of Pfizer’s and AstraZeneca’s peers are redirecting the blame — specifically to pharmacy benefit managers (PBMs) through highly produced ad campaigns.
PBMs serve as intermediaries hired by insurers and health plans to negotiate bulk discounts, manage drug formularies, and create pharmacy networks. They retain a portion of negotiated rebates while passing the remainder on to patients and plans. While PBMs negotiate these rebates, the drugmakers in charge of setting each drug’s price sometimes raise list prices so that after rebates, the drugmakers still profit more.
Critics claim that troubled PBMs inflate costs by favoring high-priced drugs with larger rebates and by using practices like “spread pricing,” where they charge health plans more than they reimburse pharmacies. But this narrative overlooks that effective PBMs also pressure drugmakers to compete, preventing them from charging full list prices unchecked. That negotiating power could be a real constraint on pharmaceutical pricing.
Former congressman Joe Pitts, former chair of the Energy & Commerce Health Subcommittee, admitted that his initial skepticism was shaped by pharma-funded attack ads. “When I dug into the data,” he said, “I quickly noticed that the truth was far different from what some of the industry’s biggest players want us to believe.”
The relationship between PBMs and Big Pharma carries blame on both sides — but it’s Americans who pay the price. Today, as many as one third of Americans skip or ration prescriptions because they simply can’t afford them.
As President Trump’s Federal Trade Commission (FTC) navigates ongoing Biden-era lawsuits against PBMs, another important key to successful PBM reforms lies in new FTC chair Andrew Ferguson’s more measured approach to that litigation. Ferguson, once a commissioner under Biden’s FTC chair Lina Khan, cautioned at that time that Biden’s FTC had “overstated” its conclusions and relied on potentially misinterpreted data. That signals a shift away from political grandstanding and toward fair, evidence-based reform.
Real reform must be twofold: Improve PBM practices where needed — potentially through settlement agreements that end those current legal battles — but maintain firm pressure on pharmaceutical companies that have long engaged in exploitative pricing. The Trump administration is well on the way to achieving that reform. Through TrumpRx.gov, new agreements such as the MFN pricing commitments from Pfizer and AstraZeneca mark an initial step toward lowering drug prices set by Big Pharma. These deals also begin to bypass certain PBMs in targeted areas, while broader PBM reforms focus on increasing transparency and accountability.
One thing is certain: Drugmakers’ routine overcharging of U.S. consumers to balance out discounts abroad cannot continue. Americans should not be forced to subsidize the rest of the world’s health care at the expense of their own health.
The most-favored-nation pledges from Pfizer and AstraZeneca are a meaningful first step. Now, as the administration continues advancing its health care accountability agenda, the remaining drugmakers must finally step up and abandon the price-gouging strategies Americans have endured for decades. That’s the path to real, lasting change — and it’s long overdue.
Kerry McQuisten is the former mayor of Baker City, Oregon who garnered national media attention when she led a statewide rebel alliance against then-governor Kate Brown’s tyrannical COVID mandates. She serves as chair of the Board for the Oregon Conservative Caucus nonprofit and as first vice president of the Baker County Republican Women. She is a senior adviser for Republicans Overseas (R.O.).
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From American Thinker
Link:
https://www.americanthinker.com/blog...rice_wall.html
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