Core Insights - The phenomenon of "one drug, two prices" in pharmacies is drawing significant consumer attention, particularly regarding the price discrepancies between in-store purchases using health insurance cards and online prices [1][2] - Consumers are struggling to understand the rationale behind these price differences, especially when they are using funds from their health insurance accounts [1] - The issue is partly attributed to the longer settlement periods associated with health insurance payments, which may lead pharmacies to pass on costs to consumers [1] Group 1 - The media has reported on a consumer's experience of purchasing medication at a pharmacy with a health insurance card, only to find that the prices were significantly higher than those available online [1] - There is a growing concern that some pharmacies may be exploiting the "one drug, two prices" model as a means to siphon off health insurance funds, especially if other pharmacies follow suit [1] - The National Healthcare Security Administration has initiated measures to improve the efficiency of health insurance settlements with designated medical institutions, which may help address these pricing discrepancies [1] Group 2 - The ongoing issue of "one drug, two prices" cannot continue, and there is a call for stricter enforcement, improved settlement efficiency, and heightened public awareness [2] - Pharmacies that focus on exploiting consumers rather than providing competitive pricing may face the risk of being driven out of the market due to increasing competition from online sales and other pharmacies [2]

Core Viewpoint - The article discusses Trump's renewed push for the "Most Favored Nations" (MFN) policy aimed at reducing U.S. drug prices by 30-80%, highlighting the challenges and complexities of implementing such a policy in the current healthcare system [3][5][17]. Group 1: Policy Announcement and Background - On May 11, Trump announced plans to sign an executive order to reinstate the MFN policy, which aims to ensure U.S. drug prices do not exceed those in other countries, particularly Canada and Mexico [3]. - This is not the first time Trump has proposed the MFN policy; a similar attempt in 2020 was halted by a federal court due to procedural issues [4][5]. - The current proposal lacks clarity on its applicability, such as whether it will cover Medicare, Medicaid, or other insurance plans, leading to skepticism from the market and media [4][5]. Group 2: Challenges in Implementation - The MFN policy faces significant hurdles, including unclear applicability across different healthcare plans in the U.S., which complicates its potential impact [11][12]. - The U.S. healthcare system's fragmented nature, with various plans negotiating prices independently, contrasts sharply with the idea of a unified pricing mechanism [14][15]. - The concept of "international minimum pricing" is problematic due to differing healthcare negotiation mechanisms and price structures in other countries, making direct comparisons difficult [16]. Group 3: Complexity of U.S. Drug Pricing - The high U.S. drug prices are attributed not solely to pharmaceutical companies but also to a complex distribution chain that includes multiple intermediaries, each adding to the final cost [20][21]. - The distribution of profits among various stakeholders in the drug pricing system shows that manufacturers, wholesalers, pharmacies, and pharmacy benefit managers (PBMs) all take a share, complicating the pricing landscape [22]. - PBMs play a crucial role in managing drug prices but often benefit from inflated pricing structures, which can obscure the true costs to patients [24][25]. Group 4: Potential Impact of the MFN Policy - Trump's claim that the MFN policy could lead to immediate price reductions of 30-80% is viewed as overly optimistic, given the limited scope of drugs that could be affected [28][30]. - The policy would primarily impact a small segment of high-cost injectable drugs, which already face significant price negotiations, limiting the overall potential for price reductions [32][33]. - Historical data from previous attempts to implement similar policies indicate that the actual savings may be minimal, with estimates suggesting only a small fraction of total drug spending could be affected [36]. Group 5: Political and Market Implications - The MFN policy, regardless of its feasibility, signals a political intent to address high drug prices, reflecting a broader consensus across administrations to tackle this issue [40][41]. - The pharmaceutical industry is warned that reliance on high pricing strategies may face increasing regulatory scrutiny, particularly as political pressure mounts for reform [43]. - The article concludes that without significant changes to the underlying healthcare payment mechanisms and transparency in drug pricing, initiatives like the MFN policy are unlikely to achieve meaningful reductions in drug costs for patients [43].