Most-Favored-Nation (MFN) foreign reference pricing is the wrong approach to lowering drug costs. It will hurt patients, endanger good-paying union jobs, and hand the strategic advantage to China—precisely when manufacturing reshoring momentum is building across the country.
Devastating Consequences for American Workers
The U.S. biopharmaceutical industry supports nearly 5 million jobs nationwide and contributes more
to America’s economy per employee than most other manufacturing sectors.1,2 The manufacturing and
research development facilities that power American innovation are built and maintained by union
pipefitters, electricians, ironworkers and other skilled building trades professionals. MFN puts these
middle-class jobs at risk.
Here’s what’s at stake. From 2019-2024, the U.S. pharmaceutical industry supported3
65 million
union labor hours
$2.6 billion
in wages for skilled
union workers
$19.5 million
in funding for union
apprenticeship programs
The U.S. Pharmaceutical Industry’s Commitment to Investing in America
$86.5 Billion
Investment by Industry,
2019-2024
1,000+
Major Projects
($5m+)
+70%
Growth in investment,
2019 – 2024
In 2025, companies have accelerated their commitments to investing in the U.S. But MFN could force billions to be redirected that would otherwise be used to invest in U.S. facilities and develop new cures.
Surrendering U.S. Leadership to China
MFN would handicap the U.S. at a time when China is attempting to overtake American leadership in
biopharmaceutical innovation and manufacturing.
A diminished U.S. life science sector would make American patients more dependent on Chinese
companies for innovative treatments.
China is rapidly advancing:
Clinical trials from China
now represent 30% of
global starts (up from
5% in 2014)4
R&D investment in
China is currently
growing 3x faster
than the U.S.5
Chinese companies now
account for 31% of firstin-
class drug candidates
(up from 9% in 2015)6
Better Ways to Lower Drug Costs
MFN won’t lead to savings for patients. Policymakers should instead address the unchecked power of
middlemen in the prescription drug supply chain – as more than half of every dollar spent on brandname
medications go to entities who don’t research, develop or manufacture these medicines.7
Middlemen such as pharmacy benefit managers (PBMs) control 80% of all prescriptions filled in the U.S.
and drive-up costs for both patients and plan sponsors.
Key PBM reforms to lower costs for U.S. patients:
Delink
PBM compensation
from drug prices
Require
PBMs to pass rebates to
patients and plan sponsors
Improve
transparency of PBM pricing
and compensation practices
Endnotes
1 TEConomy Partners, LLC. The Economic Impact of the U.S. Biopharmaceutical Industry: 2022 National and State Estimates. May 2024.
2 NDP Analytics. The Economic Performance of IP-Intensive Manufacturing and Service Industries in the United States, 2012-22. (April 2025)
3 Institute for Construction Employment Research. An Analysis of Construction Spending in the Pharmaceutical & Biotech Industry, 2019 – 2024. (May 2025)
4 IQVIA. Global Trends in R&D 2025. (March 26, 2025).
5 Organisation for Economic Co-operation and Development (OECD) Statistical Release. (March 31, 2025)
6 Tsinghua University Institute of Drug Regulatory Science & PharmCube. China’s Innovative Pharmaceutical Industry in a Global Perspective: 10-year Review and Outlook. (May 2025)
7 Berkley Research Group. The Pharmaceutical Supply Chain, 2013–2023. (January 2025)
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