The Top Questions for the President’s MFN Order

President Trump's MFN has sparked confusion in the pharma industry.

Which country is no. 1 in pharma?
According to Statista, the United States made up about 53% of the global market share for pharmaceuticals in 2024. China came in second with about 7.5%. The main reason for the significant disparity is the fact that drug prices are significantly higher in the US than other markets.

Is America the most medicated country in the world?
While some sources may claim that the United States is the most medicated country in the world, experts have disputed this. According to a USA Today report from June 2023, American prescription drug usage makes up about 8% of global prescription drug usage. However, the report does cite that 66% of American adults use prescription drugs.

What is the most-favored-nation clause in healthcare?
In May, 2025, President Trump issued an executive order stating that pharmaceutical companies must treat the United States as a most-favored-nation when setting drug costs. According to the order, this means that drugs must be the same price as the nation that pays the lowest price anywhere in the world. In the initial order, President Trump stated that he expects this to impact drug prices by 30-80%.

What is the most-favored-nation in the US?
President Trump’s most-favored-nation (MFN) order says that the United States should be treated as a most-favored-nation by pharmaceutical companies when setting drug prices. A MFN is a status a country can hold in international trade dealings which states that the MFN will receive trade benefits equal to the best version of those benefits in other countries.

Which country makes the most generic drugs?
According to the IBEF, India is the largest provider of generic drugs internationally.

Why does the US pay more for prescription drugs?
Drug companies say that drug prices are high in the United States in order to offset the costs of innovation and new drug research. In reaction to President Trump’s MFN order, industry executives responded by saying that the US’ pricing policies rewarded long-term investment in high-risk, high impact R&D.

What is MFN in pharma?
President Trump’s executive order on drug pricing states that the United States should be treated as a most-favored-nation when it comes to drug pricing. This means that drug costs should be the same in the United States as the lowest price anywhere else in the world, according to the President’s order.

How much are drugs in the US compared to other countries?
According to a 2024 report from HHS, US drug prices were 2.78 times as high as in comparison countries, even when accounting for rebates.

Which companies did President Trump publish letters to?
In late-July, President Trump published letters to the following pharma companies: AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Novartis, Gilead Sciences, EMD Serono, Pfizer, Novo Nordisk, Astra Zeneca, Amgen, Genentech, Johnson & Johnson, GSK, Merck, Regeneron Pharmaceuticals, Sanofi, and Eli Lilly and Company. The letters said that the companies had not met requirements of the MFN order and that they each had 60 days to work with the administration to do so.

When does the MFN order take effect?
The timeline for the MFN has shifted dates. The initial order gave companies 30 days to meet the requirements, which would have been June 11, 2025. However, in late July, President Trump gave companies another 60 days to meet the requirements, which would put the latest deadline at September 29, 2025. These deadlines, however, are simply just for companies to begin making progress.