The Realistic Path to Making MFN Pricing Permanent

Former U.S. Representative Joe Cunningham (D-SC) and spokespersons for the Pharmaceutical Reform Alliance assesses the political viability of making Most-Favored-Nation (MFN) pricing permanent as the midterm elections approach. He identifies affordability as the single biggest issue facing voters, with the cost of prescription drugs serving as one of its central components.

Cunningham cites polling data to support his case: three-quarters of voters say pharmaceutical company profits are a major factor in high drug prices, and 71% say the same about executive compensation, which he interprets as evidence that the public already understands the problem stems from corporate greed.

He emphasizes this is a genuinely bipartisan issue, supported by data showing 90% of voters blame pharmaceutical companies for high healthcare costs, and 76% say a candidate's position on lowering drug prices matters more to them now than it did a year ago. Cunningham breaks this figure down further by party, noting that support holds at 80% among Democrats, 75% among Republicans, and 71% among Independents, underscoring that the issue transcends typical partisan divides.

Given this level of cross-partisan support, Cunningham argues that the issue should be "low-hanging fruit" for anyone running for office or already serving in office. His central point is that if an issue performs this well at the ballot box, it should translate just as easily into policy success.

He positions codifying Most-Favored-Nation pricing into law as the most direct path available for lowering prescription drug costs, reinforcing a theme that runs throughout his broader remarks, that reforms which do not directly and measurably affect what consumers pay at the pharmacy counter fall short of the goal that matters most.

Alongside MFN codification, Cunningham raises a second policy priority: shortening patent protections in the United States so that generic drugs can reach the market sooner. He cites public opinion data showing that 85% of Americans support this change specifically because it would result in lower prescription drug costs, framing generic competition as another concrete lever for reducing prices rather than a supply-chain contingency measure.

Cunningham characterizes efforts like the voluntary API reserve as potentially well-intentioned but ultimately a distraction from the measures that would have the most direct impact on affordability. He draws a clear distinction between initiatives aimed at supply chain resilience and those aimed squarely at cost, in his assessment, only a limited number of measures, specifically MFN codification and shortened patent protections, actually address the driving high prices and are capable of putting more money back into