On September 30, 2025, during a joint White House press conference, Pfizer announced a landmark pricing agreement to lower drug costs in the U.S. under a Most Favored Nation (MFN) model.
For our broker partners and valued clients, here’s what we know so far—and why it’s something to watch closely:
- Rollout will begin with Medicaid: Every state Medicaid program will be the first to access Pfizer drugs at MFN prices in 2026—unlocking millions in savings.
- Direct-to-consumer next: Next, the federal government will launch TrumpRx.gov, giving American consumers direct access to Pfizer medicines at MFN or below-market prices.
- Future medicines at parity: From now on, all new Pfizer drug launches will be priced at or below levels in other developed nations, narrowing the U.S. “price gap.”
While Medicaid and direct-to-consumer channels are the first to see change, the ripple effects on private insurance and employer-sponsored coverage remain uncertain.
What is MFN Pricing?
Most Favored Nation (MFN) Drug Pricing is designed to set U.S. drug costs by benchmarking against international markets rather than inflated list prices. It:
- Begins at net prices (after rebates and fees).
- Benchmarks against a “basket” of wealthy countries.
- Uses the lowest international price for each drug as the U.S. MFN price.
The Pfizer agreement is structured around five ‘Pillars of Fairness’ established by the administration:
- Direct access for patients: In early 2026, the administration will launch TrumpRx.gov, a direct-to-consumer purchasing platform. Pfizer has committed to offering most of its medications at MFN or below-market pricing, bypassing intermediaries and creating greater transparency. The agreement requires Pfizer to offer medicines at a deep discount off the list price when selling directly to American patients.
- Lowest prices for the vulnerable: Medicaid programs will be the first to benefit, with every state slated to gain access to MFN pricing on Pfizer products.
- Future-proofing fairness: Moving forward, newly launched Pfizer medicines will not be priced higher in the U.S. than in other wealthy nations. This requirement applies across commercial, Medicare, Medicaid, and cash-pay markets.
- Shared savings: As foreign governments agree to pay more for existing Pfizer medications, part of that additional revenue must be repatriated to the U.S.—helping fund R&D and driving down U.S. drug prices.
- Commitment to onshore: Finally, Pfizer has pledged to onshore 100% of the value of all current imports into the U.S., reinforcing domestic pharmaceutical manufacturing.
What’s in it for Pharma?
In exchange, Pfizer will receive a 3-year reprieve on tariffs for its pharmaceutical products.
Direct-to-Consumer Pricing Examples
Several high-profile drugs were highlighted during the announcement with deep discounts for patients purchasing directly through TrumpRx.gov:
- Eucrisa (atopic dermatitis)
- Xeljanz (RA, psoriatic arthritis, ulcerative colitis)
- Zavzpret (migraines)
| Drug | Current WAC (Monthly) | Announced Discount | Estimated* Future Discounted Price |
| Eucrisa (100gms/month) | $1,115.68 | 80% | $223.14 |
| Xeljanz 5mg (60 tablets/month) | $6,073.14 | 40% | $3,643.88 |
| Xeljanz XR 11mg (30 tablets/month) | $6,073.14 | 40% | $3,643.88 |
| Zavzpret (8 doses/month) | $1,510.64 | 50% | $755.32 |
*Calculated as current monthly WAC less identified discount
What This Means for Brokers & Employers
While Medicaid and consumers are set to see the first changes, the bigger unknown is how this policy shift could ripple into private insurance and employer-sponsored coverage. While those implications remain uncertain, any disruption to pharmacy benefit structures could have downstream effects for plans and members.
Navion will continue to monitor developments closely and provide updates to our broker partners as more details emerge.
