America's patients deserve the world's best healthcare — innovative treatments that save lives, delivered at prices that don't bankrupt families. For too long, we've subsidized global drug innovation while bearing the brunt of the costs, with Americans paying three times more for brand-name drugs than in other OECD countries, even after discounts.
President Donald J. Trump's aggressive actions to end this injustice — demanding that pharmaceutical companies provide the best prices to Americans — marks a pivotal moment in putting our nation first.
In July, the White House outlined a clear directive to manufacturers: implement most-favored-nation (MFN) pricing for Medicaid patients, ensure no sweeter deals abroad for new drugs, enable direct-to-patient sales at those rates, and leverage trade policies to hike international prices while redirecting savings to U.S. consumers. This was amplified in early August with pointed warnings, including potential tariffs of up to 250 percent on imported drugs if compliance isn't met by September 29.
These steps build on a May executive order, highlighting how the U.S., representing less than 5 percent of the global population, funds 75 percent of worldwide pharmaceutical profits — essentially propping up socialist healthcare systems overseas.
Trump's ultimatum is a necessary confrontation, compelling pharmaceutical companies to prioritize American families over foreign subsidies. Yet, tying U.S. prices directly to those in other nations risks unintended consequences. MFN, without careful safeguards, could import foreign-style price controls, diminishing the incentives that fuel U.S. biomedical leadership — where 90 percent of new medicines are developed. This might delay breakthroughs for cancer, rare diseases, and chronic conditions, ultimately harming the very patients we aim to help.
The evidence underscores the peril: Simply aligning with low foreign prices ignores the freeriding that allows other countries to underpay. Trump's emphasis on raising prices abroad through tariffs and negotiations is bold, but we must avoid market distortions that could stifle innovation.
A superior approach exists—one rooted in conservative, free-market principles: the Most Favored Patient (MFP) Initiative, spearheaded by economists like Stephen Moore, former White House adviser Dr. Tomas Philipson, and Steve Forbes. This framework advances Accountability, Competition, and Transparency (ACT) reforms to drive down costs organically, without controls.
Key elements include:
Direct-to-consumer sales: Letting manufacturers sell directly to patients and pharmacies, sidestepping middlemen like insurers and pharmacy benefit managers (PBMs) who siphon off billions in rebates — aligning with Trump's direct-sales push but amplifying competition.
Combating foreign freeriding: Via robust trade deals or a NATO-like pact, compelling wealthy nations to contribute fairly — perhaps tied to GDP — boosting revenues to lower U.S. prices, much like Trump's tariff strategy.
Tackling waste and abuse: Mandating that PBM rebates and discounts flow straight to patients, and reforming the 340B program to prevent hospitals from profiteering on aid meant for the vulnerable — saving billions for taxpayers and improving outcomes.
Securing U.S. dominance: Incentivizing domestic research, manufacturing, and jobs to counter threats from China, while harnessing AI in partnerships with agencies like the NIH and FDA to accelerate affordable innovations.
These reforms enjoy broad appeal, with battleground-state polling showing 86% support for direct sales, 78 percent for fair-share trade policies, and 85 percent for 340B fixes. Since January, U.S. innovators have pledged over $300 billion in domestic investments, demonstrating how freeing markets spurs progress.
As Philipson articulates, the aim is a system that generates life saving therapies, reduces costs through competition, and keeps development firmly in America. Trump's negotiations, fortified by tariff leverage, offer an ideal chance to integrate these ideas, delivering sustainable relief.
Let's seize this opportunity: Champion markets that innovate and heal, ensuring American patients — not foreign systems — reap the rewards. When we lead with free-market ingenuity, everyone benefits.
Terry Wilcox is the co-founder and CEO of Patients Rising, empowering patients and caregivers to advocate for reforms that put them — not monopolies — in control of their healthcare choices through grassroots advocacy, education, and patient-inspired policy reforms.