OPINION: Beijing Is Coming for America's Medicine Cabinet, and Washington Is Making It Easier

Beijing can gain leverage over American families without a shooting war. Owning the pipeline of new medicines would be enough, and China moves closer to that every year.

Jeffrey Mazella, president of the Center for Individual Freedom, laid out the problem in The Washington Times (https://www.washingtontimes.com/news/2026/aug/15/beat-china-america-must-first-cut-red-tape/) in August. Beijing has made biotechnology a national priority and keeps government money flowing behind it. China can now move a molecule from discovery to clinical trial 50% to 70% faster than the rest of the world. By his count, China's share of early-stage drug programs reached 35% in 2024, about four times what it was a decade earlier.

Wall Street is seeing it too. Morgan Stanley projects (https://www.morganstanley.com/insights/articles/china-biotech-boom-generics-to-innovators) that drugs originating in China will make up 35% of FDA approvals by 2040, up from about 5% today. Congress's own National Security Commission on Emerging Biotechnology (https://www.biotech.senate.gov/wp-content/uploads/2025/04/NSCEB-Full-Report-%E2%80%93-Digital-%E2%80%934.28.pdf) concluded last year that "China is quickly ascending to biotechnology dominance, having made biotechnology a strategic priority for 20 years." If China gets to biotech's breakthrough moment first, the commission warned, "no matter how fast we run, we will never catch up."

One of Washington's favorite ideas right now would hobble the American side of that race. The administration has signed voluntary "Most Favored Nation" pricing agreements with 17 of the largest drugmakers (https://www.whitehouse.gov/wp-content/uploads/2026/05/Savings-from-MFN-Drug-Pricing-Policy.pdf) and says it is working with Congress to make them permanent law. A House bill, the Most Favored Patient Act (http://meuser.house.gov/media/press-releases/meuser-introduces-bill-lower-prescription-drug-prices), would require any manufacturer that has not signed a deal by December 2028 to provide MFN pricing in Medicare for five years.

The pitch is easy to follow. Tie what Americans pay to what other wealthy countries pay. The catch is how those countries get their prices. Their governments set them by decree. Pegging American prices to those numbers brings in the same price controls conservatives have warned against for decades. They just come in through a side door.

The President was right to go after foreign freeloading. Locking foreign price benchmarks into federal statute would be a different and far worse move, because the money for the next cure has to come from somewhere. Mazella points out that venture funding rounds for U.S. biotech fell by more than 25% from 2024 to 2025, and he ties federal and state price-control efforts directly to that pullback. Generics take a hit too. Health economist Melanie Whittington estimated for Leerink's Center for Pharmacoeconomics (https://leerink.com/article/the-price-of-lower-drug-prices/) that every additional $140 million in brand-name sales before a patent expires is associated with about one more generic competitor in the first year. Cut that revenue by government order and patients should expect fewer cheap generics later on.

Washington can go after freeloading another way, and the administration has already proved it works. Under its deal with the United States, Britain agreed to spend around 25% more on innovative medicines (https://www.gov.uk/government/news/landmark-uk-us-pharmaceuticals-deal-to-safeguard-medicines-access-and-drive-vital-investmentfor-uk-patients-and-businesses), raising the cost-effectiveness threshold its health agency uses from £20,000-£30,000 to £25,000-£35,000 per quality-adjusted life year. More of that, please. Make the countries riding on American research pay more, and stop asking American patients to accept their rationed prices.

The other half of the affordability problem lives in the middle of the supply chain. According to the Federal Trade Commission, the three biggest pharmacy benefit managers processed nearly 80% of the roughly 6.6 billion prescriptions (https://www.ftc.gov/news-events/news/press-releases/2024/07/ftc-releases-interim-staff-report-prescription-drug-middlemen) filled in 2023. A follow-up FTC report found those same three marked up specialty generic drugs for cancer, HIV and other serious illnesses by hundreds and even thousands of percent (https://www.ftc.gov/news-events/news/press-releases/2025/01/ftc-releases-second-interim-staff-report-prescription-drug-middlemen), pulling in more than $7.3 billion above estimated acquisition costs from 2017 through 2022. A foreign price benchmark won't touch any of that.

Louisiana got to this fight before Washington did. Last year Gov. Jeff Landry pushed to bar PBMs from owning pharmacies. CVS responded by texting customers that it would have to close more than 100 stores. Attorney General Liz Murrill then filed three lawsuits against the company (https://www.nola.com/news/politics/louisiana-cvs-pbms-drug-prices/article_0fde2197-0ece-4906-817c-8396d14b8e94.html). Lawmakers also passed reforms tightening how PBMs profit and requiring more disclosure. Washington should take notes.

It also needs to clear its own regulatory brush. In June, HHS launched Operation TrialBlazer (https://www.hhs.gov/press-room/hhs-launches-clinical-trials-reform-initiative.html) to speed up early clinical trials in the United States, and the FDA has opened an expedited pilot (https://www.fda.gov/news-events/press-announcements/fda-launches-expedited-ind-pilot-begins-accepting-applications) for first-in-human studies. Mazella wants to go further, toward safe trials measured in months rather than years, and toward stronger patent protection.

Louisiana has homework of its own. This year the Legislature created a Prescription Drug Affordability Board (https://www.legis.la.gov/legis/ViewDocument.aspx?d=1483288) that takes effect January 1, 2027. One of its duties is an annual list of drugs whose cost in Louisiana is "excessively high when compared with the cost of the drug in other states and countries." That is MFN thinking, now showing up in Baton Rouge. Colorado shows where boards like this can end up. Its board has already adopted an upper payment limit on Enbrel (https://doi.colorado.gov/sites/doi/files/documents/Adopted%20UPL%20Rule%20for%20Enbrel_1.pdf), a government-set ceiling that starts in 2027. Louisiana's board should stay a reporting body and nothing more.

When MFN codification comes up for a vote, our congressional delegation will have a say. They should push for tougher terms on foreign freeloaders and for real PBM reform. Then they should vote no on writing Europe's price list into federal law while Beijing keeps building labs.