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VT's Grumpies Talk MFN

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In this episode of the Vital Health Podcast, host Duane Schulthess sits down with two Vital Transformation colleagues to explore key trends in drug pricing and macroeconomic policy:

They unpack the Trump administration’s “Most Favored Nation” approach as applied to Medicaid, contrast it with past Medicare proposals, and discuss modeled employment, tax, and GDP impacts. The conversation explores why effects would differ by company and therapy area, the EU’s move toward streamlined compulsory licensing, the knock-on risks for premiums and investment, the fragility of the generics market, and how global competition - including China’s growing clinical footprint - could reshape innovation incentives.

Key Topics:

  • MFN Basics: What is MFN?, Medicaid focus versus Medicare, price-leveling concept.

  • Modeled Impacts: Jobs and GDP effects, tax revenue losses, insurance premium pressure.

  • Uneven Company Effects: Medicaid-heavy portfolios, orphan and rare disease exposure, negotiation dynamics.

  • EU Signals: Compulsory licensing push, UK pricing realities, risks of spillover to U.S. policy.

  • Innovation and Competition: Biologics cost structure, generic market fragility, and China’s rising clinical pipeline.

Opinions expressed are those of the speakers.

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Vital Health Podcast

Duane Schulthess, Managing Director of Vital Tran…
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