How Could MFN Pricing Impact Commercial Market?

Jun 12
Jun 12, 2025

While it appears unclear whether the administration is intending for most-favored nation (MFN) pricing to apply to commercial health plans, most stakeholders agree that it would be extremely difficult to do. But if the administration is successful in putting MFN into effect in at least Medicare, private insurers could feel the impact. AIS Health, a division of MMIT, spoke to a handful of industry experts on how MFN pricing, as introduced in a May 12 executive order (EO), could affect the commercial market.

Michael Abrams, managing partner of Numerof & Associates: Lower domestic drug prices would reduce utilization costs for the 50% or so of patients across the country who are on some form of government insurance. And even though it may have no direct authority over reimbursement rates in the commercial insurance space, those prices are public, and they would inevitably become a data point influencing commercial reimbursement.
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Angela Maas

Angela has an extensive background of editing, reporting and writing for trade and consumer publications. She has written Radar on Specialty Pharmacy since she joined AIS Health in 2005 and has broad knowledge of the various issues at play within the space. She also has written for Spotlight on Market Access since its 2017 launch. Before joining AIS Health, she was managing editor at Employee Benefit News and Employee Benefit News Canada and managing editor at Hem Aware (a hemophilia publication), Lupus Living and Momentum (a multiple sclerosis publication). She has a B.A. in English and an M.A. in British literature from Arizona State University.