Most Favored Patient Act of 2026

The Most Favored Patient Act of 2026, HR7837, requires the Center for Medicare and Medicaid Innovation (CMMI) to test a model implementing most-favored-nation (MFN) drug pricing. This model, effective January 1, 2029, mandates that specified manufacturers provide access to the lowest global price for covered drugs to Medicare-eligible individuals. This is a direct mechanism to lower drug prices within the Medicare system by leveraging international pricing benchmarks. Funding for Medicare drug purchases will be reallocated. Instead of paying higher U.S. prices, the government will pay the MFN price, effectively transferring billions in potential revenue from pharmaceutical companies to Medicare savings and potentially to beneficiaries through lower out-of-pocket costs. No new appropriations are involved; this is a cost-reduction measure for the government and a revenue-reduction measure for drug manufacturers. The mechanism is regulatory, compelling manufacturers to comply with the MFN pricing model. Historically, similar MFN pricing proposals have faced strong opposition from the pharmaceutical industry. In November 2020, the Trump administration issued an interim final rule to implement a Most Favored Nation Model for Medicare Part B drugs. This rule was blocked by federal courts in December 2020, preventing its implementation. While the previous attempt did not fully materialize, the announcement of the rule in November 2020 led to a temporary dip in pharmaceutical stocks, with the NYSE Arca Pharmaceutical Index ($DRG) falling approximately 2% in the week following the announcement, before recovering after the court injunctions. This bill represents a renewed legislative effort to achieve similar price controls. Specific pharmaceutical companies with high-revenue drugs covered by Medicare stand to lose significant revenue. This includes major players like Pfizer ($PFE), Johnson & Johnson ($JNJ), Merck ($MRK), Eli Lilly ($LLY), Amgen ($AMGN), Gilead Sciences ($GILD), Biogen ($BIIB), Vertex Pharmaceuticals ($VRTX), Regeneron Pharmaceuticals ($REGN), and Bristol Myers Squibb ($BMY). These companies will be forced to reduce their U.S. prices for Medicare-covered drugs to match the lowest prices offered in other developed nations. The bill is currently in committee, and the next step is committee consideration and potential markup. If it passes committee, it moves to a floor vote. The earliest market impact would be upon significant progress through the legislative process, with full implementation by January 1, 2029. Rep. Meuser (R-PA) is a junior member, which indicates this bill faces an uphill battle without broader bipartisan support or endorsement from senior committee members. However, drug pricing remains a perennial issue, and even a junior member's bill can gain traction if it aligns with broader legislative priorities.