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How Trump’s 2025 Drug Price Gambit Revived an Old Trade Concept
The Price of Privilege: With New Winners and Losers
In 2025, the U.S. government has done something that Big Pharma has feared for years: it has invoked the Most Favoured Nation clause not for diplomacy but drug pricing.
The executive order, signed with Trump’s characteristic flourish and followed by a cascade of partisan soundbites, is a bombshell. Under the new rule, Medicare will pay no more for prescription drugs than the lowest price charged in any developed nation.
A populist punchline, yes, but also a seismic shift in how the world’s most lucrative pharmaceutical market sets prices.
Some hail the move as a long-overdue correction to Big Pharma’s global arbitrage model. Others, particularly pharmaceutical lobbyists, neoliberal economists, and trade hawks, warn of dire consequences: reduced R&D budgets, vanishing innovation, and global market distortions.
But beneath the headlines and the noise, a deeper story emerges, one about power, access, and who gets to call “fair” in a system that was never built to be just.
