📢 My new @NEJM article: "U.S. Research Leadership at a Crossroads" examines the proposed 15% cap on @NIH indirect cost rates (ICRs). This threatens the foundation of US medical research leadership. #NIHfunding 1/6

RT @MarilynHeineMD: 🚨New AMA report analyzes the #pharmacybenefitmanager (#PBM) market concentration & its impact. The report reviews the….

Join millions who have switched to Grok.

For a longer summary of our article @JAMA_current:

Our article was one of a few recent @JAMA_current articles on "Most Favored Nation" drug pricing and @MedicareGov price negotiation by @bnrome @DusetzinaS @thomasmd and others that help explain the current state of the US drug pricing landscape.

The urgency is real, but the “Most Favored Nation” drug pricing policy is unlikely to deliver lasting reform. In @JAMA_current, @Eddie_Cliff and I propose accelerating and strengthening @MedicareGov drug price negotiation to align prices with value.

RT @JAMA_current: Viewpoint: To effectively reduce drug costs, the US needs its own price negotiation framework rather than relying on inte….

RT @amarkelkar: New in @JAMA_current: The 2025 “Most Favored Nation” (MFN) drug pricing policy rightly captures the necessary urgency in lo….

RT @NishantUppal7: Excellent overview in @JAMA_current by @suhas_gondi and @bnrome on the recently announced most favored nation (MFN) poli….

10/ The MFN policy reflects urgency—but not durability or long-term strategy. With the right reforms, Medicare negotiation can do better: lower prices faster, fairer, and without derailing innovation. 📰 Full Viewpoint in @JAMA_current:. @Eddie_Cliff

9/ These changes would:.• Lower prices sooner.• Improve equity and access.• Support innovation responsibly.• Strengthen Medicare and help private insurers who benchmark to Medicare rates.

8/ Our proposal:.✔️ Let Medicare start negotiation 1 year after approval (like Germany).✔️ Use independent cost-effectiveness assessments.✔️ Delink provider reimbursement from drug prices to align incentives

7/ But the IRA has a critical delay: negotiation only begins 9 years after launch (13 for biologics). During that gap, taxpayers and patients foot the bill for high prices at peak sales volume.

6/ We already have a better tool: Medicare drug price negotiation, passed in the 2022 Inflation Reduction Act. First-year results (which go into effect in 2026)?.📉 >50% reductions in negotiated drug prices.💸 ~$100B in projected savings over 10 years.

5/ What’s worse, MFN could become self-defeating. If other countries raise their list prices in response, US prices would go up too, undermining the very goal of the policy.

4/ The 2025 order threatens to revoke FDA approvals or sue companies that resist. It also gives HHS just 30 days to set prices without specifying how. That’s a recipe for legal gridlock, not real reform.

3/ But MFN’s approach is deeply flawed:.❌ Legal and constitutional vulnerabilities.❌ Opaque global pricing benchmarks (obscured by secretive rebates).❌ Risk to rare disease innovation.❌ Possible retaliation or unsafe drug imports.❌ Could unintentionally raise US prices.

2/ The US pays 2–3x more for prescription drugs than peer nations. MFN aims to fix this by capping Medicare prices to the lowest paid abroad. For example: $17,000/month ➝ $900/month for a cancer drug like lenalidomide.

New in @JAMA_current: The 2025 “Most Favored Nation” (MFN) drug pricing policy rightly captures the necessary urgency in lowering US drug costs—but is likely to face fierce opposition. We propose accelerating & improving on Medicare drug price negotiation.

RT @MarilynHeineMD: AMA to HHS Sec:. “USPSTF…critical, non-partisan role …helping to ensure access to evidence-based clinical preventive se….