For decades, the United States has shouldered a disproportionate share of global pharmaceutical costs, accounting for 70% of global biopharma profits and over 80% of new drug launches, largely due to its historical exclusion of government-led drug price negotiations. While this has helped drive significant medical innovation and supported the majority of global drug launches, it has also resulted in higher out-of-pocket costs for American patients.

A 2025 executive order targets a 30–80% reduction in prescription drug prices through a Most Favored Nation (MFN) pricing model. However, its implementation faces legal, logistical and enforcement challenges, raising questions about the feasibility and overall impact of the policy.

Structural Shifts Driving Long-Term Change

Beyond high-profile policy proposals, the most durable changes to U.S. drug pricing are likely to emerge from broader structural shifts already underway.

• A potential ban on direct-to-consumer advertising has reentered the policy conversation.
• PBM legislative reform has renewed bipartisan momentum and is already spurring industry shifts.
• FDA biosimilar reforms aim to streamline biosimilar approvals.

As the U.S. drug pricing landscape continues to shift, leaders must focus on transformative currents rather than high-profile announcements to effectively adapt and thrive in the new drug pricing ecosystem.

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