April 28, 2026 

Dear Representatives:   

On behalf of over 300,000 grassroots supporters and activists across the nation, the Center for Individual Freedom (hereinafter CFIF) writes to express strong opposition to ongoing proposals to codify a federal “Most Favored Nation” (MFN) pharmaceutical pricing policy into law.  

Although we must collectively continue efforts to lower healthcare costs for American families, MFN policies would not achieve that end.  Instead, they would ultimately undermine competition, restrict patient access and weaken America’s global leadership in medical innovation.

That’s because an MFN framework by definition imports foreign government price controls into the United States healthcare system.  Those nations typically used as benchmarks for importing MFN pricing rely upon centralized price-setting regimes that disregard patient access and timely availability of care.  Consequently, by tethering American prices to those dictated by foreign bureaucracies, MFN would displace the competitive forces and value-based negotiations that currently drive innovation and access in the United States, replacing them instead with rigid, top-down mandates. 

Those consequences aren’t speculative nor benign — they’re inescapable for several reasons. 

First, price controls inevitably reduce the availability of treatments, particularly for seniors and patients suffering from complex or rare conditions.  When governments artificially suppress reimbursement rates, manufacturers face diminished incentives to introduce new therapies into the U.S. market.  That means delayed product launches, limited distribution and elimination of certain offerings altogether.  In turn, that means fewer options for patients who often cannot afford to wait. 

As a second point of emphasis, the United States remains the world’s leader in pharmaceutical and biotechnology innovation precisely because our system rewards research, risk-taking, and success.  The development of new therapies is an extraordinarily costly and uncertain endeavor, requiring sustained investment over many years.  Codifying MFN pricing therefore discourages research and development, chilling the very innovation pipeline that has delivered life-saving and life-enhancing treatments for millions of Americans and patients worldwide.  Over time, that translates into fewer breakthroughs, slower progress and diminished long-term health outcomes. 

Additionally, MFN pricing does not eliminate costs, it merely redistributes them in ways that are less transparent and often more burdensome.  Rather than meaningfully lowering total healthcare expenditures, such policies would shift costs elsewhere in the system, manifesting as higher insurance premiums, reduced provider participation or narrower treatment options.  American patients would pay more in indirect ways while receiving less in return. 

More broadly, codifying MFN would establish a troubling precedent for federal price controls across the healthcare sector.  Once the federal government assumes the authority to peg prices to foreign systems in one domain, it becomes far easier to expand that model to others.  The result would be a gradual but unmistakable erosion of patient choice and private-sector competition, replaced by inflexible regulatory frameworks that history has shown to be ill-suited to delivering either affordability or quality. 

Fortunately, more effective and sustainable pathways to reducing healthcare costs that do not require importing the failed policies of other nations exist.  Congress should focus on strengthening market competition, enhancing price transparency, reforming benefit design to better align incentives and removing regulatory barriers that distort pricing and limit consumer choice.  Those reforms would preserve the dynamism of the American healthcare system while addressing legitimate concerns about affordability. 

For these reasons, CFIF respectfully urges you to reject efforts to codify MFN pricing policies.  In their place, we encourage the pursuit of reforms that protect patient access, promote continued innovation and preserve the competitive principles that have made the United States the global leader in healthcare advancement. 

Thank you very much for your focus on this important matter, and please contact me at your convenience with any questions or comments.