Midsize Biotechs Form Coalition to Fight Trump's MFN Drug Pricing Policy

Ten midsize biotech companies launched the Midsized Biotech Alliance of America to combat the Trump administration's Most Favored Nation drug pricing policy, warning it would "destroy biotech innovation" and threaten U.S. global leadership.

A group of 10 domestic midsize biotech companies has launched the Midsized Biotech Alliance of America (MBAA) to fight the Trump administration's Most Favored Nation drug pricing policy, which they warn poses an existential threat to their businesses. Members including Acadia Pharmaceuticals, Madrigal Pharmaceuticals, Travere Therapeutics, Alkermes, Alnylam, Ardelyx, BioMarin, Exelixis, Incyte and Neurocrine Biosciences collectively represent $7 billion in annual U.S. R&D investment and employ 12,000 people.

The MFN policy, introduced via executive order in May 2025, seeks to lower U.S. drug prices by aligning them with the lowest prices paid by comparable nations. While more than a dozen major pharmaceutical companies have signed MFN agreements often winning immunity from import tariff threats midsize biotechs lack the commercial portfolios to absorb revenue losses.

"MFN would destroy biotech innovation in this country," said MBAA spokesperson Alanna Temme, warning the policy "could wipe them off the map."  Unlike large pharma companies that can offset lower prices on some drugs with higher revenues from others, midsize biotechs often rely on just one marketed product after years of investment. MBAA members take an average of 25 years to turn a profit on drug candidates.

The coalition aims to fill an advocacy gap between PhRMA, which represents larger organizations, and BIO, which undertakes broader industry advocacy. Members are urging policymakers to adopt free-market solutions rather than what Acadia Pharmaceuticals CEO Catherine Owen Adams called a "peanut butter blanket approach" to drug pricing.

MBAA also warns that stifling U.S. innovation would cede ground to China, which continues strong biotech growth while Europe reprioritizes competitiveness. "Midsize biotechs are the lifeline to make sure we maintain being the world leader in healthcare innovation," Temme said.