White House digs in on ‘most-favored nation’ drug pricing despite Congress’ cool reception

STAT  News – Tuesday, March 17, 2026
By Daniel Payne

Despite a cool reception from Congress, the White House is looking to intensify its pressure campaign on lawmakers to pass legislation that would codify a “most-favored nation” drug pricing policy, according to two Trump administration officials briefed on the conversations.

The administration has been pushing Republicans on Capitol Hill to pursue a sweeping health care package that would mean changes for providers, insurers, federal agencies, and patients. But much of the focus has been on creating legislation aimed at bringing the cost of medications to levels below what other peer countries pay.

So far, lawmakers have been far from receptive to such an idea, with Republicans characterizing the effort as government overreach that would be counter to free-market ideals, one of the officials said. But the White House isn’t backing down.

“We’re gearing up for war,” said one administration official about the plan, speaking on condition of anonymity to discuss internal deliberations.

The commitment to codifying the most-favored nation drug pricing policy is part of a larger political goal for the administration: making health care more affordable. But, for the pharmaceutical industry, the initiative — if successful — threatens to rewrite the U.S. government’s rules of engagement in health care.

While the administration has already struck drug-pricing deals with 16 of the largest companies in the sector — the details of which remain largely confidential — it has made clear it wants its plan signed into law, which would make it resistant to future administrations’ changes, potential lawsuits, and other limitations of administrative action.

President Trump has already begun putting political pressure on Congress to act.

“Our plan finally puts you first,” he said in a videotaped address announcing the plan in January. “I’m asking Congress to complete the work that we’ve started.”

Most-favored nation pricing has become the primary focus of “many, many conversations” between the White House and lawmakers, another White House official told STAT.

”That’s the one that there’s the most back-and-forth on,” the person said, noting that administration proposals around new transparency requirements or health savings accounts are far less controversial.

Discussions on drug pricing have become more detailed, moving beyond “just the very broad blueprint that we released a few months ago.” The person declined to offer details of the discussions.

Though the chances of immediate action on legislation are low, the pharmaceutical industry is increasingly focused on how lawmakers are reacting to policy pushes from the Trump White House.

“The first thing on the top of the agenda is: What’s happening with MFN?” one lobbyist who works for pharmaceutical companies and who spoke on condition of anonymity to describe internal discussions, told STAT.

Congress has batted down drug pricing efforts from the White House previously, even when there was a party-line legislative package that could have served as a vehicle for the policy. Still, the Trump White House remains unpredictable, the lobbyists have noted. And there has been some movement on the Hill recently.

Earlier this month, Pennsylvania Rep. Dan Meuser (R) introduced the “Most Favored Patient Act,” a bill that, if passed, would require most-favored nation pricing through a Center for Medicare and Medicaid Innovation (CMMI) model for five years for drugmakers that don’t enter separate deals with the administration.

Previously, Sen. Bill Cassidy (R-La.) discussed a similar drug pricing plan, while Sens. Josh Hawley (R-Mo.) and Peter Welch (D-Vt.) introduced their own bill last year that would link U.S. drug prices to what other countries pay.

But more recent meetings between administration officials and key lawmakers haven’t produced new legislation or movement toward it, at least not publicly. Some lawmakers in a meeting in late January appeared skeptical of the proposal, according to a person in the room.

There are more immediate causes for concern for drugmakers, though. The Centers for Medicare and Medicaid Services recently announced CMMI models that would look to implement most-favored nation pricing without congressional action.

To avoid those models, some smaller companies have been inquiring about making deals with the administration similar to those made by 16 of the largest companies in the sector.

CMS Administrator Mehmet Oz made the case for legislation on most-favored nations pricing directly to drugmakers last month, arguing that a future administration may be “more drastic, draconian” in its approach to drug pricing.

“We want to codify MFN in a way that industry finds is reflective of what was signed in the contracts, the deals that were done,” he said.

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