Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients (Trump EO Tracker)

This order makes it the policy of the United States to have the most-favored-nation price for prescription drugs and biologics.

The order directs the Secretary of Commerce and the United States Trade Representative to take all necessary and appropriate action to ensure foreign countries are not engaged in any act, policy, or practice that may be unreasonable or discriminatory or that may impair United States national security and that results in American patients paying for a disproportionate amount of global pharmaceutical research and development.

The Secretary of Health and Human Services (Secretary) shall facilitate direct-to-consumer purchasing programs for pharmaceutical manufacturers that sell their products to American patients at the most-favored-nation price.

The order establishes Most-Favored Nation Pricing by requiring:

1. Within 30 days of the date of this order, the Secretary shall, in coordination with the Assistant to the President for Domestic Policy, the Administrator for the Centers for Medicare and Medicaid Services, and other relevant executive department and agency officials, communicate most-favored-nation price targets to pharmaceutical manufacturers to bring prices for American patients in line with comparably developed nations.
2. If, following the action described in subsection (a) of this section, significant progress towards most-favored-nation pricing for American patients is not delivered, to the extent consistent with law:
   1. the Secretary shall propose a rulemaking plan to impose most-favored-nation pricing; 
   2. the Secretary shall consider certification to the Congress that importation under section 804(j) of the Federal Food, Drug, and Cosmetic Act (FDCA) will pose no additional risk to the public’s health and safety and result in a significant reduction in the cost of prescription drugs to the American consumer; and if the Secretary so certifies, then the Commissioner of Food and Drugs shall take action under section 804(j)(2)(B) of the FDCA to describe circumstances under which waivers will be consistently granted to import prescription drugs on a case-by-case basis from developed nations with low-cost prescription drugs;  
   3. the Attorney General and the Chairman of the Federal Trade Commission shall, to the extent consistent with law, undertake enforcement action against any anti-competitive practices identified in the report issued under EO 14273 - Lowering Drug Prices by Once Again Putting Americans First, including through use of sections 1 and 2 of the Sherman Antitrust Act and section 5 of the Federal Trade Commission Act, as appropriate;
   4. the Secretary of Commerce, and the heads of other relevant agencies as necessary, shall review and consider all necessary action regarding the export of pharmaceutical drugs or precursor material impacting global price discrimination;
   5. the Commissioner of Food and Drugs shall review and potentially modify or revoke approvals granted for drugs, for those drugs that maybe be unsafe, ineffective, or improperly marketed; and
   6.  the heads of agencies shall take all action available, in coordination with the Assistant to the President for Domestic Policy, to address price discrimination.

Additional Documentation

• Trump Executive Order - Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients