President Donald Trump announced on Monday that his administration has finalized agreements with nine additional pharmaceutical companies to lower prescription drug prices in the U.S. through the most-favored-nation (MFN) policy, bringing the total number of participating firms to 26 and covering 90% of the domestic pharmaceutical market.
The new deals involve Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals, and UCB, which will offer discounted drugs to state Medicaid programs and provide new medications at the lowest global prices via the TrumpRx portal. The White House projects the agreements will save Americans more than $600 billion over a short period. The companies have also committed to investing $19.6 billion in domestic manufacturing, according to administration officials.
Policy Expansion and Mechanism
The MFN policy, revived via an executive order in May 2025, ties U.S. drug prices to the lowest prices charged in other developed nations. The deals require participating companies to sell medications to Medicaid at prices aligned with foreign markets, though state participation remains optional. The policy builds on existing agreements with 17 larger drugmakers, including Pfizer, Eli Lilly, and Novo Nordisk, which have already adjusted commercial strategies in response.
Economic Impact and Consumer Access
Administration officials, including Chris Klomp, senior adviser to Health and Human Services Secretary Robert F. Kennedy Jr., cited a 0.8% decline in pharmaceutical prices in July and a 3.1% drop from last year—the steepest annual decline in over 60 years—as evidence of the policy’s early effects. The TrumpRx website, launched in February, aggregates discounted name-brand medications for consumers. Officials claim the initiative has made drugs more affordable for Americans, though critics note that Medicaid already receives steep discounts under federal law, raising questions about direct consumer savings.
Manufacturing and Market Shifts
The agreements require companies to expand domestic production, with some firms redirecting billions to U.S.-based facilities to avoid potential tariffs. The policy has also prompted drugmakers to increase direct-to-consumer marketing and expand online sales channels, including through TrumpRx. The White House framed the deals as a response to what it describes as “global freeloading” by pharmaceutical companies, arguing that U.S. consumers have historically paid higher prices than patients in other developed nations.
Background and Context
The MFN policy was first introduced in 2020 but faced legal and operational challenges before being revived in 2025. The administration has framed the latest expansion as a key achievement ahead of the November midterm elections, emphasizing healthcare affordability as a central campaign issue. The policy’s voluntary nature and reliance on corporate cooperation distinguish it from previous legislative attempts to regulate drug pricing, such as the Inflation Reduction Act’s Medicare negotiation provisions.
Reactions and Unanswered Questions
While administration officials touted the agreements as historic, independent analysts noted that the $600 billion savings estimate has not been independently verified. The impact on out-of-pocket costs for consumers remains unclear, as Medicaid’s existing discount structure may limit direct benefits to patients. Additionally, the policy’s long-term sustainability depends on continued corporate participation and enforcement mechanisms, which have not yet been fully detailed by the White House.