In brief SOTU remarks, Trump asks Congress to "codify" MFN
Despite delivering a record-setting hour and forty-eight minute speech with a major focus on the economy and affordability, US President Donald Trump devoted less than four of those minutes to his administration's efforts to lower drug prices.
In his brief remarks, the President likely overstated the effects of the policy and asked Congress to "codify the Most Favoured Nations programme into law", though it's not entirely clear what it would mean to legally codify voluntary agreements with private companies.
"Under my just-enacted Most Favoured Nations agreements, Americans, who have for decades paid by far the highest prices of any nation anywhere in the world for prescription drugs, will now pay the lowest price anywhere in the world," Trump said.
In fact, the government itself has described the policy as benchmarking prices to a subset of countries with comparable GDPs, not the whole world. More to the point, because the MFN deals are not public, it's hard to evaluate how much savings they're delivering but many analysts have argued that the prices being touted were often already available through existing discounts or via generics.
The relative downplaying of MFN in the speech comes as somewhat of a surprise, given the broad, bipartisan appeal of lower drug prices as the midterm elections approach. Trump's brief remarks on MFN came about 40 minutes into his speech and lasted less than four minutes.
Trump introduced a guest, Catherine Rayner, whom he described as the first patient to benefit from the lowered drug prices available via TrumpRx. Rayner, who is taking IVF drugs for infertility, was able to obtain a $4,000 drug for $500, according to the President.
In closing, President Trump repeated a request to Congress to "codify" MFN, originally made a few weeks ago when the administration unveiled their "Great Healthcare Plan".
"So now I'm calling on Congress to codify my Most Favoured Nation programme into law," he said. "Now on the one hand I'm not sure it matters because It's going to be very hard for someone who comes after me to say 'Let's raise drug prices by 700 or 800 percent', but John and Mike [Senate Majority Leader John Thune and Speaker of the House Mike Johnson], if you don't mind, codify it anyway."
As discussed on a recent pharmaphorum podcast, MFN could refer to several administration initiatives: a series of voluntary agreements entered into with private pharma companies, a pair of Medicare pilot programmes, or the aforementioned TrumpRx platform. Of those, the CMS programmes make the most sense as something that could be codified into law, but we'll have to wait for an actual bill to parse the meaning for certain.
