A few weeks back, at the Chief Patient Officer Summit, the Most Favoured Nation (MFN) drug pricing policy kept finding its way into the conversation.
Well, sounds reasonable, right? How can we talk about building a patient-centric enterprise without discussing a pricing policy that could change what patients pay for medicines, and where those medicines become available.
And, from what we heard, It was evident that MFN was already having an impact on the industry!
“Our company isn't backfilling roles on our team because of MFN” - Patient Advocacy Professional at Top Pharma, Canada
We saw that concern reflected in the patient organization activity captured by Zebricks too, across policy statements, community education, and calls for action.
For those of us working in advocacy, these activities give us something useful to work with. They paint a clear picture of how the ecosystem is shifting giving you insight on how you can prepare or handle the change.
Across the past 18 months, we identified 101 MFN-related activities from 36 patient organizations.
There was plenty of disagreement. Some saw a chance to bring down unaffordable drug prices. Others worried that patients could end up waiting longer for treatment, or losing access altogether.
The idea behind MFN drug pricing is straightforward: tie U.S. medicine prices to the lowest prices paid for the same medicines in comparable countries.
It gained momentum with the May 2025 executive order. By August 31, 2026, the White House reported agreements with 26 manufacturers representing 89% of the branded drug market. (Note: the 89% describes the market represented by the manufacturers; it does not mean every prescription now comes at an MFN price. The agreements include provisions for Medicaid and new medicines, with the details determining who benefits and how.)
However, national policy decisions can have a global impact, and we see MFN policy drawing responses well beyond the U.S
Outside the U.S., the concern is that a lower local price could affect what a manufacturer earns in a much larger market. Patient advocates worry that companies could respond by seeking higher prices elsewhere or delaying launches. The Gastrointestinal Society has been explaining these risks to Canadian patients. GI Society’s MFN explainer
Of the 36 organizations in our search, 30 were headquartered in the U.S. and six elsewhere: two in Canada, and one each in Belgium, Denmark, Slovenia, and Czechia.
We see the vast majority of engagement is anchored in the United States, with 30 out of 36 organizations (including the global and local groups) based there. This clearly reflects that MFN is fundamentally recognized as an aggressive U.S. reimbursement reform.
Taking a closer look at geographic scope of these patient organizations, tells us a bit more about how MFN is perceived within the advocacy sector.
We see a high number of patient groups with a national scope (26, out of 30 in U.S) reacting to MFN. Advocacy groups clearly perceive MFN as a macroeconomic, federal crisis that requires high-level lobbying in Washington, D.C., rather than state-by-state legislative defense.
The inclusion of 1 Continental organization in Belgium and 3 Global organizations reinforces that the global healthcare community views U.S. pricing models as having a definitive impact on worldwide R&D funding and international drug availability.
The fact that national organizations in Canada, Denmark, Slovenia, and Czechia are mobilizing indicates a strong anticipation of ripple effects. Ex-U.S. groups are likely recognizing that tying the massive U.S. market to their local prices could impact global drug supply chains, future R&D investment, and launch sequencing in their own countries.
We also took a closer look at the kind of activities the patient organizations are engaged in. We saw that 97 of the 101 activities are focused on System influence, alongside three education activities and one research brief.
Patient organizations are putting considerable effort into shaping MFN policy into health-system decisions.
The mix of organizations was interesting, too. Sixteen worked across general health, chronic disease, or the needs of groups such as older adults and caregivers. Disease-focused organizations covered neurology, cancer, digestive conditions and rare diseases.
With 44% of the active groups falling under broad disease area or demographic advocacy, the pushback is largely being managed by professional policy coalitions rather than grassroots or specific disease communities.
Patient organizations focussed on therapeutic areas that are heavily reliant on Medicare Part B (specifically rheumatology, ophthalmology, and nephrology) are less vocal. Even oncology and rare diseases, which face massive exposure to Part B reimbursement changes, show surprisingly low direct engagement.
These five organizations recorded the most activities in Zebricks.
The two most active organizations approach MFN very differently. Following both helps us understand the competing expectations your teams may encounter during conversations with patient communities. However, here are a few broad themes that surfaced.
For groups supporting MFN, the appeal is clear: medicines cost too much, and patients need relief. AARP argues it will lower prescription costs for older Americans citing projections of nearly $200 billion in Medicare savings.
However, even those organizations supporting MFN, there were calls for more clarity. For instance, Patients For Affordable Drugs NOW (P4ADNOW), the most active organization in our search, called for more transparency, details on enforcement, and whether savings would be lasting.
Other organizations were concerned about what patients might lose under MFN.
The Partnership to Improve Patient Care (PIPC) raised objections to referencing prices from systems that use quality-adjusted life years, or QALYs, in assessing treatments. Its concern is that these approaches can disadvantage people with disabilities and chronic conditions. (Note: this is an argument about the systems behind the reference prices; it should not be read as a claim that MFN directly requires U.S. use of QALYs).
The Partnership to Fight Chronic Disease and Chronic Care Policy Alliance raised related concerns about treatment availability, innovation, and the stability of care delivery. They advocate for alternatives such as pharmacy benefit manager reform, rather than MFN.
For communities elsewhere, the question is whether changes intended to make medicines cheaper for Americans could make them more expensive, or harder to obtain, at home.
In Canada, the Gastrointestinal Society warns that linking U.S. prices to lower Canadian prices could give manufacturers reasons to delay launches or seek price increases. It is calling for changes to Canada’s approach to medicine access and reimbursement. GI Society’s position
The organizations we identified in Europe and Canada show that this conversation already crosses borders.
This is why we find monitoring patient group activity across markets particularly useful. A Canadian group organizing a discussion about launch access gives a global team a reason to check in with local colleagues and partners. They can ask whether they are hearing similar concerns, what evidence is available, and what information patients need.
Financial Sponsorship & Grants: Pharma organizations (e.g., AbbVie, Merck, AstraZeneca) actively provide educational grants and sponsor policy conferences, such as the GI Society’s patient-led Action Plan addressing MFN’s impact in Canada.
Joint Forums & Education: Industry representatives participate in webinars and policy updates (alongside patient advocates, such as the Cancer Patients Europe webinar and Global Liver Institute), quarterly meetings to evaluate how MFN could delay drug launches and widen access inequalities.
Aligned Advocacy Against QALYs: The industry and numerous patient coalitions (like the Partnership to Improve Patient Care and the Alliance for Safe Biologic Medicines) share unified opposition to MFN. They collectively argue that tying U.S. prices to foreign metrics imports discriminatory Quality-Adjusted Life Years (QALYs) that devalue the lives of individuals with disabilities and stifle medical innovation.
Upcoming Industry Events:
A useful place to start is the next conversation with a patient partner. Hopefully, this article helps you show up informed to the conversation and ask more targeted questions.
There are two clear approaches; One to engage your patient communities for grassroots advocacy (as we see from our data, there's lots of opportunity here).
The other, is to educate the patient community on MFN and what it could mean for them.
Finally, it would be a good idea to do an internal audit to see if MFN would delay launches or impact clinical trial recruitment and intentionally plan for those scenarios in your advocacy strategy.
At CPO, we talked about building a patient-centric enterprise. Part of that work is making sure the questions patient communities are raising reach the people inside our companies who can act on them, and going back to those communities with a response.
What are you noticing in your patient communities? Is there a specific topic you're interested in knowing more about?
Get a custom feed tailored to your priorities.