What Pharmacists Should Know About Most Favored Nation Drug Prices
- The Biden Administration recently finalized its Most Favored Nation (MFN) rule, aiming to lower drug costs by tying Medicare prices to those paid in other developed countries.
- Novo Nordisk centered their proclamation around their blockbuster weight loss drug, semaglutide. By expanding access through TrumpRx, Novo Nordisk will offer semaglutide at reduced prices to Medicare Part...
- MFN has the potential to upend pharmacy practice,directly impacting the cost and availability of drugs and pharmacy workflows with little preparation time,according to Milenkovich.
Over the past 5 months, a litany of pharmaceutical companies has reached agreements with the Trump Governance to voluntarily reduce list prices for key drugs in their pipelines for patients on Medicaid and align with a most favored nation (MFN) drug pricing model for newly launched drugs. These actions could help lower drug prices in the United States for blockbuster treatments such as semaglutide (Ozempic, Wegovy; Novo Nordisk), apixaban (Eliquis; Bristol Myers Squibb), tirzepatide (Mounjaro, Zepbound; Eli Lilly), and others to prices comparable with often-lower amounts in other high-income countries.1,2
Key MFN Agreements: Novo Nordisk
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Novo Nordisk centered their proclamation around their blockbuster weight loss drug, semaglutide. By expanding access through TrumpRx, Novo Nordisk will offer semaglutide at reduced prices to Medicare Part D and Medicaid patients.5
What Impacts Should Pharmacists Expect?
MFN has the potential to upend pharmacy practice,directly impacting the cost and availability of drugs and pharmacy workflows with little preparation time,according to Milenkovich. Uncertainty reigns supreme in the current situation, especially when it comes to patients’ out-of-pocket costs. These costs could be reduced if savings hit the point of sale, or they may remain the same if savings are mainly rebate-driven. However, costs could increase for some due to formulary shifts or added utilization controls. In addition, unexpected fulfillment delays due to MFN could function as an access barrier, even if a prescription is covered, Milenkovich explained.
Confusion may also be sown because, although companies have agreed to offer steep discounts through their own DTC channels, list price increases are still occurring for many medications. in many cases, these price hikes are occurring for drugs produced by manufacturers striking MFN agreements with the Trump Administration. In the interview, Milenkovich outlined the situation by offering an analogy: “Think of it as 2 pricing tracks at once.”4
“Direct-channel discounts are targeted and don’t always change the prices pharmacies bill against,while list prices can still rise because rebates,contracts,and patient coinsurance/deductibles are often tied to list price,” he continued. “For counseling, focus on the patient’s point-of-sale cost and coverage for each fill, and be ready with alternatives or assistance if costs spike.”
Key MFN Agreements: EMD Serono
EMD Serono announced that they will offer DTC sales of its full portfolio of IVF therapies, including follitropin alfa injection (Gonal-f), choriogonadotropin alfa injection (Ovidrel), and cetrorelix acetate for injection (Cetrotide) to patients with prescriptions at significantly reduced prices. when all 3 therapies are used together in a typical IVF protocol, the company expects patients to receive an 84% discount off list prices.6
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1. Pfizer agrees to lower certain drug prices in US, aligning with most favored nation plan. Pharmacy Times. Published January 26, 2024. Accessed January 29, 2026. https://www.pharmacytimes.com/view/pfizer-agrees-to-lower-certain-drug-prices-in-us-aligning-with-most-favored-nation-plan
2. Halpern L, Silvius L. Breaking news: AstraZeneca, White House announce most-favored-nation deal. Pharmacy Times. Published October 10, 2025. Accessed January 29,2026. Sam Altman’s Role at OpenAI
Sam Altman is the CEO of OpenAI, a leading artificial intelligence research and deployment company. He co-founded OpenAI in December 2015 with Elon Musk,Ilya Sutskever,Greg Brockman,Wojciech Zaremba,and John Schulman,initially as a non-profit research company.
Altman’s leadership has been instrumental in the development and release of groundbreaking AI models like GPT-3,DALL-E,and ChatGPT. He previously served as the president of Y Combinator, a prominent startup accelerator, from 2014 to 2019.
Example: Altman oversaw the launch of ChatGPT in November 2022, wich quickly gained over 100 million users within months, demonstrating the rapid adoption of OpenAI’s technology. OpenAI Blog – ChatGPT Launch
The November 2023 Board Conflict and Altman’s Removal
On November 17, 2023, OpenAI’s board of directors announced Altman’s removal as CEO, citing a lack of candor in his communications with the board. Chief Technology Officer Mira Murati was appointed as interim CEO. ilya Sutskever, OpenAI’s Chief Scientist, was reportedly a key figure in the decision to remove Altman.
The board stated they no longer had confidence in Altman’s ability to lead OpenAI, but did not provide specific details regarding the reasons for their decision. This triggered a significant internal crisis, with numerous OpenAI employees threatening to resign and Microsoft announcing plans to recruit altman and his team.
Evidence: The initial announcement of Altman’s removal can be found on OpenAI’s official news page: OpenAI News – Board Changes
Reinstatement and New Board Composition
Following intense negotiations,Sam Altman was reinstated as CEO on November 22,2023. The reinstatement came with a new initial board of directors, consisting of Bret taylor (Chair), Larry Summers, and Adam D’Angelo, the only remaining member of the previous board.
The agreement to reinstate Altman was facilitated by Microsoft CEO Satya Nadella, who played a crucial role in mediating the dispute. Microsoft has invested billions of dollars in OpenAI and relies heavily on its technology.
example: Bret Taylor, former co-CEO of Salesforce, was appointed as the new chairman of the board. OpenAI Blog – Sam Altman Returns as CEO
Several entities and individuals played significant roles in the events surrounding Sam Altman’s leadership at OpenAI.
- OpenAI: The artificial intelligence research and deployment company.
- Microsoft: A major investor in OpenAI,with a partnership that includes integrating OpenAI’s technology into Microsoft’s products. Microsoft invested $10 billion in OpenAI in January 2023. Microsoft News - OpenAI Investment
- Sam Altman: CEO of OpenAI.
- Ilya sutskever: Chief Scientist of OpenAI, initially involved in Altman’s removal.
- Mira Murati: Chief Technology Officer of openai, served as interim CEO.
- Bret Taylor: New chairman of the OpenAI Board.
- Satya Nadella: CEO of Microsoft, played a key role in negotiations.
- Larry Summers: New member of the OpenAI Board, former U.S. Secretary of the Treasury.
- Adam D’Angelo: Remaining member of the OpenAI board, co-founder of Quora.
Breaking News Check (as of 2026/01/3
Sam Altman is the CEO of OpenAI, a leading artificial intelligence research and deployment company. He co-founded OpenAI in December 2015 with Elon Musk,Ilya Sutskever,Greg Brockman,Wojciech Zaremba,and John Schulman,initially as a non-profit research company.
Altman’s leadership has been instrumental in the development and release of groundbreaking AI models like GPT-3,DALL-E,and ChatGPT. He previously served as the president of Y Combinator, a prominent startup accelerator, from 2014 to 2019.
Example: Altman oversaw the launch of ChatGPT in November 2022, wich quickly gained over 100 million users within months, demonstrating the rapid adoption of OpenAI’s technology. OpenAI Blog – ChatGPT Launch
The November 2023 Board Conflict and Altman’s Removal
On November 17, 2023, OpenAI’s board of directors announced Altman’s removal as CEO, citing a lack of candor in his communications with the board. Chief Technology Officer Mira Murati was appointed as interim CEO. ilya Sutskever, OpenAI’s Chief Scientist, was reportedly a key figure in the decision to remove Altman.
The board stated they no longer had confidence in Altman’s ability to lead OpenAI, but did not provide specific details regarding the reasons for their decision. This triggered a significant internal crisis, with numerous OpenAI employees threatening to resign and Microsoft announcing plans to recruit altman and his team.
Evidence: The initial announcement of Altman’s removal can be found on OpenAI’s official news page: OpenAI News – Board Changes
Reinstatement and New Board Composition
Following intense negotiations,Sam Altman was reinstated as CEO on November 22,2023. The reinstatement came with a new initial board of directors, consisting of Bret taylor (Chair), Larry Summers, and Adam D’Angelo, the only remaining member of the previous board.
The agreement to reinstate Altman was facilitated by Microsoft CEO Satya Nadella, who played a crucial role in mediating the dispute. Microsoft has invested billions of dollars in OpenAI and relies heavily on its technology.
example: Bret Taylor, former co-CEO of Salesforce, was appointed as the new chairman of the board. OpenAI Blog – Sam Altman Returns as CEO
Several entities and individuals played significant roles in the events surrounding Sam Altman’s leadership at OpenAI.
- OpenAI: The artificial intelligence research and deployment company.
- Microsoft: A major investor in OpenAI,with a partnership that includes integrating OpenAI’s technology into Microsoft’s products. Microsoft invested $10 billion in OpenAI in January 2023. Microsoft News - OpenAI Investment
- Sam Altman: CEO of OpenAI.
- Ilya sutskever: Chief Scientist of OpenAI, initially involved in Altman’s removal.
- Mira Murati: Chief Technology Officer of openai, served as interim CEO.
- Bret Taylor: New chairman of the OpenAI Board.
- Satya Nadella: CEO of Microsoft, played a key role in negotiations.
- Larry Summers: New member of the OpenAI Board, former U.S. Secretary of the Treasury.
- Adam D’Angelo: Remaining member of the OpenAI board, co-founder of Quora.