Commentary: Americans Should Not Have to Pay the World’s Highest Drug Prices

Americans have been paying too much for prescription drugs for too long, and the rest of the developed world has been allowed to pay too little by comparison.

That is the central issue raised in the Council of Economic Advisers’ May 2026 report, Savings from Most-Favored-Nation (MFN) Drug Pricing Policy. The report argues that the United States consistently pays much higher prices for brand-name drugs than other wealthy countries, and that American patients and taxpayers have borne a disproportionate share of the costs of global pharmaceutical innovation.

This report should not be the end of the discussion, but rather a serious starting point for Congress and policymakers who claim they want to lower health care costs.

The CEA report says U.S. prices for brand-name drugs were about three times higher than prices in selected peer nations, even after accounting for manufacturer rebates and discounts. It also notes that the United States accounts for more than half of pharmaceutical manufacturers’ revenue, and as much as 75 percent for top-branded drugs, while making up less than 5 percent of the world’s population.

That is not fair.

Americans support medical innovation. We want new cures, better treatments, and continued research. But supporting innovation should not mean American families, seniors, employers, and taxpayers are expected to subsidize the rest of the world without question.

The Trump Administration’s Most-Favored-Nation drug-pricing framework aims to address that imbalance. According to the report, the policy is aimed at brand-name drugs and biologics that do not face generic or biosimilar competition. The goal is to align U.S. prices more closely with those in other high-income countries, while also pressuring those countries to pay more of their fair share.

That matters because prescription drug costs are not an abstract budget issue. They show up at the pharmacy counter. They affect seniors choosing between medicine and groceries. They affect families paying out of pocket for fertility treatments. They affect people trying to access weight-loss drugs, diabetes treatments, cancer medications, and other life-changing prescriptions.

The report estimates that prospective MFN pricing for future drug launches could generate $529 billion in domestic savings over 10 years across all markets. It also estimates that applying MFN prices to existing Medicaid drugs could save $64.3 billion over 10 years, including $36.6 billion for the federal government and $27.6 billion for states.

Those numbers should get lawmakers’ attention.

The report also points to direct savings for patients through TrumpRx.gov, especially for drugs often purchased outside insurance. It estimates that uninsured users of GLP-1 weight-loss drugs could save $3,000 per year, and couples undergoing in-vitro fertilization could see savings exceeding $6,000 per live birth.

For many families, that is real money.

Congress should move to protect and expand this approach. Voluntary agreements are useful, but patients need stability. Drug companies, insurers, pharmacies, states, and families all need to know the rules will not disappear with the next political cycle. If the policy is producing savings, Congress should work to codify it in a way that protects patients and taxpayers while preserving incentives for new drug development.

That does not mean the policy should escape scrutiny. Lawmakers should examine the details carefully. They should ask whether the savings estimates are realistic, how prices will be audited, how the policy will affect smaller drug manufacturers, and whether foreign governments will actually pay more. They should also make sure that lower U.S. prices do not result in reduced access or delayed launches for American patients.

But asking hard questions is different from doing nothing.

For too long, Washington has talked about lowering drug prices while Americans keep paying more. The MFN framework directly challenges that broken system. It says the United States should no longer be the world’s blank check for prescription drugs.

That is a debate worth having.

Congress should take this report seriously, hold public hearings, demand clear numbers from drug manufacturers, and move toward a lasting policy that gives Americans the best prices available among wealthy nations. Other countries should contribute fairly to the cost of medical innovation, and American patients should not be punished for living in the country that leads the world in research and development.

Lower drug prices should not be a Republican issue or a Democratic issue. It should be an American issue.

The CEA report gives policymakers a framework. Now Congress should have the courage to act.