This week on the Making Medicine Podcast, John Stanford dives into the “Most Favored Nation” (MFN) pricing concept, championed by President Trump, and what it could mean for drug pricing, innovation, and patients in America. Could aligning U.S. drug prices with those abroad actually save patients money, or would it crush innovation and access? John unpacks the trade-offs of MFN, the global free-riding problem, the role of PBMs, and the rise of direct-to-patient drug models. The episode explores whether America already is the most favored nation in pharmaceuticals and what bold moves are next.

What do you think: Should the U.S. demand lower prices from drug companies or protect innovation at all costs?
Would a direct-to-patient model work better than today's broken system?

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Timestamps:
0:00 The History of Most Favored Nation
1:06 Trump Brings MFN Back into Focus
1:22 Welcome to Making Medicine
2:19 Why Drug Pricing Became the MFN Battleground
3:04 Trump's Push for MFN & the Pharma Letter
4:02 The Personal Story Driving Trump’s Policy
5:00 The Appeal and Simplicity of MFN
5:19 Industry Pushback & Potential Consequences
6:02 America’s Role in Global Drug Innovation
7:06 Why MFN Could Damage U.S. Biotech
7:25 The Costco Analogy & Why It Fails
8:20 Global Free-Riding and What Other Nations Don’t Pay
9:00 The U.S. Middlemen Problem (PBMs)
10:03 Global Solutions and Missed Opportunities
11:01 Generics: The Hidden Strength of the U.S. System
12:43 What Happens If Generics Vanish?
13:14 Trump's Unclear Path Forward
13:46 Direct-to-Patient Sales: A Better Path?
14:42 Is the U.S. Already the Most Favored Nation?
15:30 Final Thoughts on MFN & What Comes Next