The opinions expressed in this piece are solely the author’s and do not necessarily reflect the views of Carolina Journal or its publisher.
North Carolina has spent decades building one of the nation’s leading life sciences economies — supporting high-paying jobs, advanced manufacturing, cutting-edge research, and the development of medicines patients depend on. From the Research Triangle to hubs across the state, more than 800 life sciences companies drive innovation that improves lives worldwide. That success was built through long-term investment, public-private collaboration, and a policy environment that encouraged innovation, risk-taking, and growth. Now, Washington is considering a proposal that could undermine this foundation.
Congress is considering a “Most Favored Nation” (MFN) drug pricing model that would effectively import foreign government price controls into the US healthcare system by tying American medicine prices to those set overseas. Supporters frame the proposal as a way to lower costs, but what often goes unsaid is how those lower prices are achieved abroad: through aggressive price controls, restricted access to medicines, and slower availability of new treatments.
Patients in countries with government price-setting systems often wait longer for access to new medicines and have access to less than half as many treatments for complex conditions like cancer, neurological disorders, autoimmune diseases, blood disorders, and rare diseases. While nearly 90% of new medicines are available quickly for patients in the US, only 63% are available in Germany and 59% in the UK.
Developing a new medicine is expensive and risky, often requiring years of research and billions of dollars in investment with no guarantee of success. When price controls reduce the potential return on that investment, companies and investors become less willing to fund the next generation of research, clinical trials, manufacturing expansion, and startup innovation. A recent analysis found combined policy pressures, including MFN, could reduce the number of new medicines approved in the US by up to 55% over the next two decades. Because a new medicine typically takes 10 to 15 years to develop, the decisions made today that impact new drug availability will shape which treatments are available years from now. Policies that will reduce new treatments coming to market can set back years of progress, leaving patients waiting for cures that may never arrive.
North Carolina’s life sciences ecosystem depends on a network of venture capital firms, startup biotech companies, university research partnerships, and early-stage investors willing to fund high-risk scientific research years before a product ever reaches patients. From early-stage oncology and rare disease research to advanced manufacturing and cell and gene therapy development, many of the state’s most promising medical breakthroughs begin as small, high-risk ventures that rely on sustained private investment. Developing breakthrough therapies often requires investors to commit capital despite long timelines and the potential of failure.
Venture capital and private investment are highly mobile. Investors can choose to allocate capital to software, artificial intelligence, medical devices, or late-stage compounds rather than early-stage, high-risk biotech research. If policymakers reduce the potential returns that offset biotech’s extraordinary scientific and financial risks, more investors will move away from funding the early-stage innovation that produces breakthrough therapies. This early-stage funding sustains a cycle in which private capital fuels discoveries, discoveries become new treatments, and returns from those treatments finance the next round of research, so when returns become unsustainable, the whole cycle breaks down.
These decisions about where to invest in manufacturing and research have real consequences for communities across North Carolina. Life sciences manufacturing anchors local economies, from the Research Triangle to Wilmington, Sanford, and the Triad. Major life sciences companies continue to expand their local presence, announcing new manufacturing facilities and research investments. Those investments reflect confidence that North Carolina remains a top-tier location to discover, develop, and manufacture the next generation of medicines.
Countries around the world are aggressively competing for biotech investment and advanced manufacturing capacity. North Carolina has emerged as a national leader because we have historically prioritized policies that reward innovation. Moving toward MFN would send the opposite signal — that America is becoming a less predictable place to invest in the next generation of cures.
Congress should pursue policies that improve affordability without undermining the innovative ecosystem responsible for developing new cures in the first place. North Carolina became a national life sciences leader because we chose policies that encouraged discovery, investment, and growth. Policymakers in Washington should be working to strengthen that foundation, not put it at risk.
