Public Citizen has scrutinized the Most-Favoured Nation (MFN) pricing deals announced by the Trump administration with 27 pharmaceutical companies. The advocacy group concludes that claims about the savings these agreements deliver are misleading.
After filing a freedom of information request and a lawsuit, it secured access to heavily redacted versions of the agreements signed with Pfizer and Eli Lilly. The organization says this lack of clarity makes it difficult to verify the President’s statements about their impact on prescription-drug prices. The analysis indicates the agreements favor the drugmakers and will not achieve the stated goals.
Loopholes in recent agreements
Public Citizen argues that the texts show the administration handing out favours to Big Pharma while undercutting its own models to lower prices. It points to a specific loophole in the Lilly deal. This provision insulates the company from providing a true MFN price point for its GLP-1 drugs, including Mounjaro for diabetes and Zepbound for weight loss.
The organization notes that the agreement allows drugmakers to discontinue entirely the supply of a medicine to other countries to manage their US MFN prices. This practice, it claims, threatens patients’ health. If Novo Nordisk received a similar carve-out for its GLP-1s like Ozempic and Wegovy, potential savings from the Medicaid pilot programme could be reduced by $1.7 billion.
These terms are not unique to Lilly. The Pfizer agreement also contains concerning aspects. The group states that the deal terms supersede the GENEROUS model used for Medicaid cost-savings. Both agreements rely on pharma companies reporting their pricing accurately “in good faith,” according to the organization. There are suggestions that drug companies may share some of the increase in net revenues from higher medicines charged overseas with the US federal government.
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Global impact and political response
The text of the Lilly deal suggests the US government is blessing the practice of withholding drugs from other markets. This ties in with comments from various pharma groups. They have indicated they may avoid launching new medicines in markets like the UK and Germany if they cannot command the prices they want.
A recent analysis in Switzerland found that pharma groups have held back from submitting around a third of their new medicines for reimbursement. This finding is linked directly to the MFN policy in the US. A group of UK lawmakers is pushing for an investigation into how the recent pharma trade deal may affect patients’ access to new drugs.
It has also come to light that the deals with the two drugmakers were not finalised when the Trump administration first publicised them. Terms were still being thrashed out for months afterwards.
“Drug company and investor statements that indicate they do not anticipate major financial impacts from the deals, and evidence that Trump has exaggerated his recent drug-pricing achievements, along with Trump’s past failures in implementing his drug-pricing policies and achieving lower drug costs, make it even more important to assess whether his rhetoric matches reality,” the group added. White House Senior Deputy Press Secretary Kush Desai implied in a social-media post that the terms Public Citizen uncovered were in the fact sheets the White House put out for every single MFN deal.
Claims about savings and final deal status
The group asserts that drug companies and investors do not expect major financial impacts from the deals. It also claims the President has exaggerated his recent achievements. There is evidence of his past failures in lowering drug costs. The group notes that the agreements were not finalized when the administration first publicized them.
