Here in Alaska, getting health care isn’t always as simple as driving a few minutes down the road. In much of our state, it can mean flying hundreds of miles to undergo a medical procedure, fill a prescription, or see a doctor. Many of our communities are off the road system, and as much as 98% of the state is officially classified as lacking adequate access to doctors and basic care. That’s our reality, and Washington, D.C., needs to understand it.
Unfortunately, a new federal proposal would only make these access challenges worse. It’s called “Most Favored Nation” (MFN) pharmaceutical pricing. The idea is to tie what Americans pay for certain prescription drugs to the lower prices paid in countries like France or Canada.
That might sound appealing, especially in a state where many families already face steep out-of-pocket costs at the pharmacy counter. But in reality, MFN would import more than just foreign price tags – it would import the access restrictions that inevitably come with them.
In countries like France and Canada, government bureaucrats decide how much a drug is worth using rigid formulas that don’t reflect the real cost of research or innovation. The result is fewer choices, longer wait times, and delayed access to the newest treatments. MFN would bring that same one-size-fits-all system to America – and Alaskans would be among the first to feel the consequences.
Basic economics tells us that when governments set prices far below market value, companies stop launching new and innovative medicines in those countries. In the United States, 85% of new medicines make it to patients. In France and Canada, where the government sets drug prices, it’s closer to half – and patients wait much longer to get them.
If MFN pricing takes hold, we could face longer waits – months or even years – for new treatments to reach our pharmacies. Here in Alaska, where access is already limited for many, patients would be hit hardest.
There is also no guarantee this policy would actually lower what Alaskans pay at the pharmacy. Insurers and middlemen – especially pharmacy benefit managers (PBMs) – ultimately decide what patients owe out-of-pocket. And there’s nothing in MFN that forces them to pass along any savings. Today, PBMs pocket about 42 cents of every dollar spent on brand-name drugs. Yet MFN leaves this broken system virtually untouched.
We also need to take a hard look at the 340B program – a well-meaning federal initiative originally designed to help low-income and rural hospitals serve vulnerable patients. Today, many large tax-exempt hospital systems exploit it by acquiring drugs at low prices and reselling them at markups of 1,000% or more. 340B has become a hospital profit engine that hurts – rather than helps – at-risk patients.
Rather than importing price caps from Europe, we should focus on market-based reforms that protect access and lower out-of-pocket costs through transparency, competition, and innovation.
American research and development fuels most of the world’s medical progress, but foreign countries demand steep discounts and expect us to foot the bill. That’s not fair. But the answer isn’t to copy their failed systems – it’s to negotiate better trade deals that ensure they pay their fair share, just like we’ve done in defense.
Alaska’s two senators know that keeping decisions local and empowering markets is essential for our state’s future. Now, they have the opportunity to reject Europe’s failures and strengthen Alaska’s self-reliance – and reject MFN before it does real damage.
Letting unelected regulators in D.C. adopt prices set by foreign governments is a direct threat to our values and our health. This isn’t just about prescription drugs. It’s about control. It’s about whether Alaskans and our doctors decide what care we get, or whether that call gets made in D.C., Paris, or Ottawa.
Alaskans don’t wait around for others to solve our problems. We take care of our own. And when it comes to health care, that means saying no to government price controls – and yes to solutions rooted in freedom, fairness, and the free market.
Bethany Marcum was CEO of Alaska Policy Forum and Alaska state director of Americans for Prosperity. She also served 23 years in the United States military.
