Advocacy group pokes holes in Trump's MFN pricing claims
A consumer advocacy group has scrutinised some of the Most-Favoured Nation (MFN) pricing deals the Trump administration has announced with 27 pharma companies and concludes that claims about the savings they deliver are smoke and mirrors.
After a freedom of information request and lawsuit, Public Citizen has secured access to heavily redacted versions of the MFN agreements signed with Pfizer and Eli Lilly, which it said has made it difficult to verify some of Trump's claims about their impact on prescription drug prices.
However, after analysing the texts, it believes the agreements favour the pharma companies and will not deliver what the President is claiming.
"Trump's drug pricing deals are a mirage, designed to convince Americans that he's taken significant action on drug pricing while creating minimal if any downside for Big Pharma," said Peter Maybarduk, access to medicines director for Public Citizen.
"The texts show Trump handing out favours to Big Pharma, undercutting his own models to lower prices, and throwing the support of the US government behind corporate decisions to deny medicines entirely to other countries."
One assertion made by the group is that Lilly's deal contains a loophole that insulates it from providing a true MFN price point for its GLP-1 drugs, such as tirzepatide-based Mounjaro for diabetes and Zepbound for weight loss.
It has calculated that if Novo received a similar carveout for GLP-1s it produces – such as Ozempic for diabetes and weight-loss therapy Wegovy, based on semaglutide – it could reduce potential savings from the GENEROUS pilot programme for Medicaid cost-savings by $1.7 billion.
"In the Lilly text, the US blesses drugmakers discontinuing entirely the supply of a medicine to other countries, to manage their US MFN prices, a practice that threatens patients' health," according to the advocacy group.
That ties in with comments by various pharma groups that they may avoid launching new medicines in some European markets like the UK and Germany, for example, if they cannot command the prices they want.
Meanwhile, in Switzerland, a recent analysis found that pharma groups have held back from submitting around a third of their new medicines for reimbursement, linking the finding 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 with the US, which hinges on MFN pricing and changes to the cost-effectiveness calculations used for NHS reimbursement, may affect patients' access to new drugs.
The Pfizer agreement also has some concerning aspects; for example, that the deal terms supersede the GENEROUS model, according to Public Citizen, which also claims that, in both cases, they rely on pharma reporting their pricing accurately "in good faith." There are also suggestions that pharma companies may share some of the increase in net revenues from higher medicines charged overseas with the US federal government.
The texts also suggest that the deals with the two drugmakers were not in fact finalised when the Trump administration first publicised them, with terms 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," it 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 that the White House put out for every single MFN deal" – a position that seems hard to defend with even a cursory review of those documents.
