MFN drug pricing risks undermining American healthcare

As someone who advocates for Ohio’s farmers and rural communities, I’ve learned that strong nations are built on two pillars: the ability to feed their people and the ability to keep them healthy. When either pillar weakens, national stability begins to wobble. That’s why the push toward a Most Favored Nation (MFN) drug pricing model should concern not only doctors and patients, but every American who cares about our longterm strength, including those of us in the fields.

MFN pricing may sound harmless, even fair. It ties the price of prescription drugs to the lowest price paid by certain foreign nations. But beneath that simple idea lies a policy that risks hollowing out the very innovation ecosystem that is building in Ohio and has kept the USA at the forefront of advanced medicine.

Agriculture has taught me that you can’t demand world class output while paying bargain basement prices. If you force farmers to sell corn at the lowest global price, you eventually lose the farms that produce the highest quality crops. The same logic applies to drug development and our innovation pipeline.

American patients benefit from the world’s most advanced therapies because our system, as imperfect as it is, has historically encouraged private sector investment in research and development. MFN pricing would effectively outsource our pricing model to countries that deliberately underpay for medicines, often because they rely on the U.S. to shoulder the cost of research and development. If we peg our prices to theirs, we risk importing their shortages, their delays, and their lower standards of access.

Rural communities already struggle with limited access to specialists, long travel times, and hospitals operating on thin margins. If MFN pricing undermines the investment that supports new treatments and cures, rural patients are likely to feel the consequences first. Fewer breakthrough treatments. Longer waits. More reliance on outdated medications.

Perhaps the most troubling aspect of MFN pricing is how it could inadvertently weaken America’s competitiveness in the global life sciences race.

China has made no secret of its ambition to dominate biotechnology, pharmaceuticals, and advanced manufacturing. While we debate policies that would shrink investment in American R&D, China is pouring billions into its labs, talent pipelines, and statebacked companies. If MFN pricing discourages U.S. firms from taking risks, launching new research programs, or scaling up domestic production, we may find ourselves increasingly dependent on foreign supply chains, especially Chinese ones.

Agriculture has already seen what happens when we rely too heavily on China for critical inputs. We should not repeat that mistake with medicines, vaccines, and biologics.

We absolutely need to address the affordability of healthcare and prescription drugs. But we should do so in ways that preserve incentives for innovation, strengthen domestic manufacturing, and focus on the parts of the system that most directly drive up patients’ out of pocket costs.

Ohio’s Congressional delegation should keep focused on advancing Pharmacy Benefit Manager (PBM) reforms to encourage greater transparency and accountability. Addressing distorting practices by middlemen in the drug supply chain and vertical integration in the broader health insurance industry are among the most effective ways to help lower costs for patients without sacrificing access to future cures.

MFN pricing, however, is a shortcut with long-term consequences.

April is National Grange Month, and the Ohio State Grange celebrates our farm families and communities. And throughout the year, the 91 Subordinate Granges in Ohio will continue working on agricultural and rural life issues important to our members, including policies that ensure access to quality healthcare.

Margaret Ann Ruhl is from Fredericktown, Ohio, and is a former State Representative of the 68th District in the Ohio General Assembly, and a member of Knox County Pomona Grange