Quick-Reference Guide

MFN, IRP & the Jargon, Explained

A quick-reference glossary for anyone jumping into this conversation cold—patients, caregivers, and policy staff alike.

How the Policies Fit Together Terms to Know Legislative Tracker

Policy Hierarchy

How the pricing policies fit together.

Start with the broad approach, then follow the hierarchy down to the specific U.S. policy and its proposed implementation models.

Broad framework Policy subtype Implementation models
IRP
Broad international pricing framework

International Reference Pricing

The umbrella practice of benchmarking one country's drug prices against prices in other countries.

MFN sits within the broader IRP framework
MFN
U.S. policy subtype

Most Favored Nation

A U.S. policy approach that would tie U.S. drug prices to the lowest price in an identified group of reference countries.

Proposed ways to implement MFN
Implementation model

GLOBE

Global Benchmark for Efficient Drug Pricing would apply an MFN-style model to certain physician-administered Medicare drugs.

Medicare Part B
Implementation model

GUARD

Guarding U.S. Medicare Against Rising Drug Costs would apply an MFN-style model to certain retail pharmacy Medicare drugs.

Medicare Part D

Terms to Know

A quick glossary of the language used in this debate.

Select a category to explore its definitions. All categories begin closed so you can reach the legislative tracker faster.

Policy Terms IRP, MFN, GLOBE and GUARD
Umbrella Term

IRP

International Reference Pricing is the broader global practice of benchmarking a country's drug prices against other countries' prices. MFN is the aggressive, U.S.-specific subtype under this umbrella term.

U.S. Policy

MFN

Most Favored Nation is a policy that would tie U.S. drug prices to the lowest price in an identified group of 19 reference countries.

Federal Models

GLOBE & GUARD

GLOBE — Global Benchmark for Efficient Drug Pricing: One of the government's proposed rules for putting MFN pricing into practice. GLOBE would apply to certain Medicare Part B drugs, including physician-administered medications.
GUARD — Guarding U.S. Medicare Against Rising Drug Costs: One of the government's proposed rules for putting MFN pricing into practice. GUARD would apply to certain Medicare Part D drugs, including retail pharmacy medications.
Pricing Terms Out-of-pocket costs, list price and net price
Patient Price

Out-of-Pocket Costs

What a patient actually pays for a prescription—copay, coinsurance, or deductible—as distinct from the drug's list or net price.

Sticker Price

List Price

The innovator's publicly posted baseline price before negotiations or discounts involving the government, insurance companies, hospitals, wholesalers, pharmacies, or others in the supply chain.

Negotiated Price

Net Price

The price after negotiations between innovators and the government, insurance companies, and others in the supply chain. It is usually lower—and sometimes far lower—than the list price.

Value of Medicines Terms QALY, evLYG, GCEA and HTA
Cost-Effectiveness

QALY

Quality-Adjusted Life Year is a cost-effectiveness measure some other countries use to price a treatment in dollars per year of “quality” life gained. Critics, including many disability and aging advocates, say it discriminates by undervaluing people who are older, disabled, or chronically ill. The ACA prohibits its use in Medicare.

Equal Life-Year Value

evLYG

Equal Value Life Years Gained values each year of life gained equally, regardless of age, disability status, or health condition. It was developed as an alternative to QALY and focuses on life extension rather than adjustments for “quality.”

Broader Value Framework

GCEA

Generalized Cost-Effectiveness Analysis tries to capture value elements a straight QALY score may miss, such as caregiver value, productivity, and equity. It has been proposed as a fairer way to assess treatment value, though it is not itself a pricing tool.

Coverage & Pricing Review

HTA

Health Technology Assessment is a process or organization that evaluates the clinical benefit and cost-effectiveness of new medicines. In many countries outside the U.S., governments use HTA bodies to make centralized decisions about which drugs are covered and at what price, such as the UK's NICE.

Additional Terms PBM and orphan drug
Insurance Middleman

PBM

Pharmacy Benefit Manager is the middleman that negotiates prices and rebates between drug manufacturers, insurers, and pharmacies—and has significant influence over what a patient actually pays at the counter.

Rare Disease Treatment

Orphan Drug

A treatment developed for a rare disease, typically involving a small patient population, high development costs, and special FDA incentives intended to encourage innovation.

Legislative Tracker

The bills & federal models to watch right now.

Most Favored Nation

Insurance Reform

Sign-On Opportunity

Patients must inform this conversation. Sign-on to our MFN opposition letter, driven by patients, caregivers, and patient/caregiver advocacy organizations.

Read & Sign the Letter Here

Questions? Want to get more involved?

We’re here to help. Reach out to the NPLB team at hello@nopatientleftbehind.org or connect with any of our webinar speakers:

Heidi Floyd

Breast Cancer Patient & Advocate,
NPLB PAAC Member
heidifloyd@gmail.com

Michael Riotto

Multiple Myeloma Patient Advocate, Coach & Mentor, NPLB PAAC Member
michaelriotto1@gmail.com

Sue Peschin

President & CEO, Alliance for Aging Research
info@agingresearch.org

DISCLAIMER: References to elected officials, candidates, political parties, legislation, or federal agencies are included solely to inform readers of relevant policy developments; they do not imply endorsement of, or opposition to, any specific candidate, party, or elected official. Bill and model details reflect their status at time of publication and may change as legislation and rulemaking progress — check the linked primary sources for the latest status.