Comment by estearum

There is no world in which an MFN clause does anything other than reduce the overall revenues to the pharma companies.

There is no world in which lower overall revenues does not reduce R&D spend.

There is no world in which lower R&D spend does not reduce the number and quality of new drugs.

This doesn't require trusting anyone about anything other than trusting that pharma companies are generally profit-seeking and therefore an MFN clause imposed by USG will create less optimal pricing (for the pharma companies' own incentives) than currently exists.

The exact price changes that happen in different localities that net out to "less revenue → less R&D → fewer drugs" is hard to predict, but the fact that it will be lower and it nets out to "less revenue → less R&D → fewer drugs" is absolutely predictable.

Please suggest an alternative outcome, if you can think of one.