Prescription Justice Stands Behind MFN Drug Pricing for America
Last year, in an executive order, President Trump declared that Americans “deserve low-cost pharmaceuticals on the same terms as other developed nations.” President Trump declared the need for “most-favored-nation” (MFN) pricing — meaning U.S. consumers should not pay more for the same medicines than people in other high-income democracies. Indeed, according to the RAND Corporation, brand-name drug prices average 422% higher in the United States than in other high-income countries.
We at Prescription Justice unequivocally share that goal. Americans deserve MFN drug prices immediately. Our focus is on supporting safe access to lower drug prices through personal importation from countries with the strongest pharmaceutical regulations, such as Australia, Canada, France, Germany, New Zealand, and the UK, or other countries where appropriate verification can support patients seeking properly manufactured, regulated, safe, and effective prescription drugs.
What the Administration Can Do Now:
1. Use existing law authorizing enforcement discretion to permit personal importation.
The Administration should prioritize allowing the safest forms of personal importation currently in use. Under Section 804(j)(1) of the FDCA, Congress directed the FDA to use enforcement discretion to permit individuals to import prescription drugs for personal use that may otherwise be prohibited when doing so poses no “unreasonable risk” to the patient. The FDA’s Personal Importation Policy is wrongly used as an excuse to deny safe and affordable prescription drug imports.
2. Grant advance waivers for personal importation.
Separately, Section 804(j)(2) of the FDCA authorizes the Secretary of Health and Human Services to issue waivers expressly allowing individuals to import lower-cost prescription drugs from abroad. Using this power would provide clarity and protection for consumers. Waivers can be granted for importation beyond Canada to countries in the European Union, Australia, New Zealand, and the UK.
3. Recognize lawful personal importation under Section 801
Not all personal drug importation is illegal. Section 801 of the Food, Drug, and Cosmetic Act (FDCA), called Imports and Exports, prohibits the importation for “commercial use” of FDA-approved products made outside the U.S., but not for personal use. In fact, the FDA says on its website that the importation of prescription drugs for personal importation is illegal in “most circumstances,” which means not all. Americans should be able to import drugs for personal use under circumstances where it is lawful.
Looking Ahead
Federal law prohibits anyone besides drug manufacturers from the wholesale importation of FDA-approved drugs, except from Canada under state drug importation programs, as described above. One of the biggest problems with those programs is that they are limited to Canada. For the long term, Canada is too small to sustain a large increase in drug importation from the U.S. With legislative reform, importation should extend beyond Canada to include the European Union, which is bigger than the U.S., has drug-safety standards equal to or exceeding our own, and where prices are often lower.
Building a fair, trans-Atlantic pharmaceutical market will move us toward true price parity — the essence of MFN pricing.
Uniting America
MFN drug pricing isn’t partisan. Whether Republican, Democrat, independent, or Libertarian, every American should agree on this: we shouldn’t pay more for the same medicines than people in other developed nations. Prescription Justice will continue to advocate importation policies to make that principle real.