Pegging U.S. drug prices to the lowest price in peer countries undermines price discrimination, delays launches in poorer markets, and can even raise prices, especially for generics. Evidence cited includes Europe’s reference-pricing delays, Medicaid’s 1991 MFN episode that lifted generic prices, and modeling (Dubois, Gandhi, Vasserman) showing limited savings versus direct bargaining. It also risks discouraging generic entry if MFN applies only to brands.
— It challenges a popular bipartisan reform by showing how reference pricing can reduce global welfare and weaken the generic engine that actually drives low costs.
EditorDavid
2025.10.05
62% relevant
Doctorow highlights Amazon’s use of most‑favored‑nation (MFN) terms that force merchants to raise prices off‑platform, mirroring how MFN provisions in drug markets can raise prices and suppress competition; both show MFN clauses as anticompetitive mechanisms that inflate prices system‑wide.
2025.09.04
84% relevant
The newsletter cites Judge Glock arguing Trump’s order to match the lowest foreign prices would have limited impact and instead urges competition via faster FDA approvals, imports, and direct-to-consumer sales—aligning with the critique that reference/MFN pricing undermines price discrimination and can raise prices or delay access.
Judge Glock
2025.09.03
90% relevant
The piece critiques Trump’s executive order to peg U.S. prices to the lowest foreign price and argues this invites gaming and won’t lower costs—mirroring the existing thesis that MFN/reference pricing undermines price discrimination and can raise prices or delay access. It also ties in how tariffs on imported drugs would raise costs, reinforcing the policy‑design critique.
Cremieux
2025.07.30
100% relevant
Discussion of Trump-era MFN plan, Europe’s reference-pricing effects, the 1991 Medicaid MFN change, and the Dubois–Gandhi–Vasserman preprint modeling IRP scenarios.