BOSTON--(BUSINESS WIRE)--Jun 25, 2025-- Out-of-pocket drug costs for seniors may rise under President Trump’s Most Favored Nation (MFN) proposal if policymakers do not address the role of pharmacy benefit managers (PBMs), according to a brief released today by the Pioneer Institute. The MFN proposal aims to link U.S. drug prices to the lowest prices in developed countries. However, if rebate contracting remains in place, lower drug prices could still translate into higher out-of-pocket costs for seniors, who may be forced to skip medications to avoid the financial burden.