A newly published peer-reviewed study in Health Affairs Scholar compares how the United States values the cost of medical treatments against countries named as Most Favored Nations (MFNs) under a 2025 presidential executive order on prescription drug pricing. The findings arrive at a pivotal moment for patients relying on high-cost medications like GLP-1 drugs, where price gaps between the US and other nations are already under intense scrutiny.
What the Study Examined
Researchers analyzed 6,876 cost-per-QALY (quality-adjusted life year) studies to compare the cost-effectiveness thresholds cited in US-based analyses versus those used in countries designated as Most Favored Nations under the 2025 executive order. Cost-effectiveness thresholds are benchmarks that help policymakers and payers determine whether a drug or health intervention delivers sufficient medical value relative to its price. A treatment priced above a country's threshold may be considered poor value; one priced below it may be considered worthwhile.
The core question the researchers set out to answer: does the US apply meaningfully different standards for what counts as "good value" compared to the nations whose lower drug prices the executive order seeks to reference?
Why This Matters for GLP-1 Patients
GLP-1 receptor agonists — including semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) — are among the most expensive widely used medications in the United States. List prices for these drugs in the US can run several times higher than what patients pay in countries like the UK, Germany, or Canada. The 2025 Most Favored Nation executive order is specifically designed to pressure drug manufacturers to bring US prices closer to the lower prices charged abroad.
If US cost-effectiveness thresholds are substantially higher than those used in MFN countries, it could mean American payers have historically been willing to accept higher prices for the same drugs — a structural difference that the executive order is attempting to correct. For patients, any policy shift that narrows this gap could affect insurance coverage decisions, out-of-pocket costs, and which GLP-1 medications remain accessible.
Key takeaway: This study provides the first systematic comparison of US drug value thresholds against the Most Favored Nations named in the 2025 executive order — research that could directly shape how GLP-1 drug prices are negotiated and covered going forward.
What Patients Should Watch For
The executive order's Most Favored Nation pricing framework is still being implemented, and its practical effect on GLP-1 prices has not yet been determined. Key developments to follow include:
- Whether manufacturers of semaglutide or tirzepatide respond to MFN pressure with formal price reductions or rebate adjustments
- How Medicare and private insurers update their coverage and prior authorization criteria if cost-effectiveness benchmarks shift
- Any follow-up research that breaks down threshold comparisons by drug class, including obesity and diabetes medications specifically
Frequently Asked Questions
Drug pricing policy is complex and evolving rapidly. If you have questions about how potential price changes might affect your access to GLP-1 medications, speak with your prescribing clinician or a pharmacist who can help you navigate your coverage options.
- Peer-reviewed journal article, 'Cost-effectiveness thresholds used in the United States vs most favored nations,' Health Affairs Scholar, 2025.