Trump PBM Reforms — Not MFN — Help Drive Historic Drug Price Drop as CHA Files Wyden Comments

WASHINGTON, D.C. — The Center for Healthcare Affordability (CHA), a project of the Institute for Legislative Analysis, filed comments today with Senate Finance Committee Ranking Member Ron Wyden on his “Commonsense Policy Options to Lower Drug Prices for Patients.”

Prescription drug prices fell 0.8% in July, amid a growing but misguided narrative crediting Most-Favored-Nation (MFN) pricing for the decline. CHA points instead to the Trump administration and Republican Congress’s broader PBM reforms, growing competition among PBMs and expanded direct purchasing.

“President Trump and Congress deserve credit for tackling problems with PBMs caused by the Affordable Care Act that have driven up prescription drug costs,” said Fred McGrath, executive director of the Center for Healthcare Affordability. “PBM reform reaches the entire prescription drug market. By comparison, just 80 of the 841 medications listed on TrumpRx — less than 10% — are Presidential Deal drugs tied to MFN.”

President Trump signed landmark PBM reforms in the 2026 spending law targeting opaque compensation, rebates and other practices that distort prescription drug prices. Direct-purchase options such as TrumpRx also give consumers new ways to bypass traditional PBM markups.

Competition is increasing as well. An Axios-reported survey of 408 employers found 46% now use a PBM outside CVS Caremark, Optum Rx and Express Scripts, up from 37% last year.

CHA’s filing strongly opposes mandatory MFN or international reference pricing, warning that it would import prices set under foreign government-controlled health care systems and undermine investment in new medicines. Instead, CHA calls for confronting foreign free-riding by requiring wealthy countries to contribute more toward pharmaceutical innovation.

“America should make wealthy countries pay more for the innovation they consume, not import their price controls here,” McGrath said. “If investors know successful medicines will ultimately be tied to government-suppressed prices abroad, fewer high-risk treatments will attract the capital needed to reach patients.”

CHA argues the same market-based approach is needed across health care. While prescription drug prices fell 0.8% in July, the overall medical care index rose 0.4% and hospital services rose 0.5%, underscoring the need to address larger health care cost drivers.

CHA’s Healthcare Reform Prescriptions calls for eliminating anti-competitive Certificate of Need laws, reducing costly hospital labor mandates, removing barriers to recovery of legitimate medical debt and reforming 340B incentives that fuel hospital consolidation.

“Price controls are not health care reform. Competition is,” McGrath said. “Washington should build on the PBM reforms already underway while tackling the hospital costs and government-created distortions still driving health care spending higher.”

In its comments to Wyden, CHA also backs greater PBM transparency, direct contracting, rebate savings for patients, stronger competition and reforms to lower the cost and complexity of developing new medicines, while opposing expanded federal price controls that threaten innovation.

The Center for Healthcare Affordability is a project of the Institute for Legislative Analysis. The Center serves as a comprehensive resource for lawmakers, employers, and policy leaders seeking practical solutions to the healthcare cost crisis and a clearer understanding of how public policy affects affordability across the system.

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