Presentation (CTI)

OBJECTIVES: This study aimed to 1) quantify historic price differentials for select therapies across US and eight ex-US markets (UK, France, Germany, Italy, Canada, Japan, Denmark, Switzerland), 2) model the impact of MFN pricing on US revenues, focusing on Medicare and Medicaid segments, and 3) assess implications for market access planning.
METHODS: We conducted a retrospective analysis using PharmOnline International (POLI) database to extract WAC (US) and ex-manufacturer prices (global) for five branded drugs—sitagliptin, sitagliptin + metformin, midostaurin, semaglutide, tirzepatide—across eight countries. US revenue estimates were derived from company reports and segmented into commercial, Medicare, and Medicaid channels using claims-based percentages. Hypothetical MFN policy impact was modeled by applying the lowest international benchmark prices exclusively to Medicare and Medicaid segments, under the assumption that commercial payer prices may remain unaffected.
RESULTS: Current global prices were 50-98% lower than the US prices across the five therapies analyzed. Modeling MFN pricing to Medicare and Medicaid segments resulted in estimated revenue declines of 15-70% for obesity and diabetes therapies and ~30% for the oncology therapy evaluated.
CONCLUSIONS: Aggregate analysis suggests MFN implementation could significantly reduce government payer expenditures and manufacturer revenue for products with MFN pricing applied. MFN drug pricing is currently only applicable through voluntary agreements between manufacturers and the US government, and is separate from concurrent US drug pricing policies like the Inflation Reduction Act Medicare Drug Price Negotiation Program. It is critical for manufacturers to assess the impact of evolving US drug pricing policies by integrating claims-derived payer mix, pricing, rebate, and market-based data in proactive scenario planning