With the recent headlines on most-favored-nation and direct-to-patient drug purchasing platforms, where should access professionals look to next?

Late September’s drug pricing negotiation from Pfizer’s for “most favored nation” (MFN) for U.S. Medicaid programs, as well as reduced prescription drug prices when selling direct-to-patient (DTP), carried into October with AstraZeneca’s similar deal. While it looks as if other pharma manufacturers will be signing on, what are some of the implications for these directions in drug pricing?

Joel White, Partner and Head of Health Practice at Monument Advocacy, a consultancy based in Washington, DC, told BioXconomy, “From my perspective, voluntary price cuts are far better than government price controls – that’s progress. How it interacts with Medicaid and 340 B, is the biggest unanswered question.”

But the more significant trend, said White, are direct-to-patient programs and the evolution of cash pay. With TrumpRx and PhRMA’s own online aggregated sites being readied for a January 2026 launch, as well as already established DTP sites from pharma manufacturers and online platforms, White said, “Consumers can walk through the door and see what a cash price is, which is great. But we think there should be a real-time comparison to what an insurance benefit would provide because 93% of people have some form of coverage.”

From there, White ticked off the list of what would comprise an informed consumer choice:

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Does the price offered compare to what the insurance company offers?

Does the cash price count against out-of-pocket requirements?

What about competing prices that could potentially drive down costs?

These unanswered questions, for the non-Medicaid population, are not very clear. And they aren’t clear in regard for Medicare Part D and the Accountable Care Act either, which would require regulatory action as well, noted White.