Impact of U.S. most-favored-nation (MFN) drug pricing on global oncology access.

11056 Background: U. S. cancer drug prices substantially exceed those in other OECD countries. In May 2025, a U. S. Presidential Executive Order mandated adoption of a Most-Favored-Nation (MFN) pricing policy, linking U. S. drug prices to those of economically comparable countries. In December 2025, the Centers for Medicare the lowest adjusted prices were observed in South Korea (2, 116) and Japan (2, 271), representing reductions of 65% and 62%, respectively. Daratumumab, the second top-selling oncology drug, was priced at 2, 831 per 400 mg in the U. S. , compared with 1, 467 in South Korea and 1, 603 in the Netherlands (48% and 43% lower). The lowest benchmark prices most frequently originated from South Korea (n=5) and the Netherlands (n=4). Norway, Germany, and Japan each provided the lowest benchmark for one drug. Second-lowest benchmark prices were observed in Japan (n=4), South Korea (n=3), the Netherlands (n=2), Germany (n=2), and Norway (n=1). Conclusions: Countries serving as the lowest-price benchmarks- particularly South Korea, Japan, the Netherlands, Norway, and Germany- may face increased risk of upward pricing pressure or delayed access to innovative oncology therapies as manufacturers seek to limit U. S. MFN rebate exposure. Expanded use of confidential discounts, confidential rebates and other managed-entry agreements may help preserve access while reducing MFN benchmark risk.