President Trump has had enough.
On May 12, 2025, he signed an Executive Order resurrecting and expanding upon a policy initiative from his first term: the Most-Favored-Nation (MFN) pricing model. In his first term, the MFN model focused on Medicare Part B drugs, those administered in clinical settings, and proposed that the US would pay no more than the lowest price paid by a comparable country.
That version was blocked by the courts in 2021 due to procedural issues and was quickly abandoned by the Biden administration. The 2025 version not only revives the core concept but also broadens its scope significantly. It retains the pricing benchmark based on peer nations while adding a novel direct-to-consumer purchasing mechanism.
This allows patients to bypass pharmacy benefit managers entirely and buy drugs directly from manufacturers at MFN prices. The new policy thus marries institutional price reform with individual consumer empowerment, expanding the ambition and reach of Trump’s original plan.
