Speaking at the Roosevelt Room event, Trump said that 14 of the country’s 17 largest drugmakers have now signed similar pledges and described the latest agreements as “the greatest victory for patient affordability in the history of American health care.” Johnson & Johnson, AbbVie and Regeneron remain outside the framework, though Trump indicated that Johnson & Johnson is expected to join “next week.”
The executive order backing the initiative was signed on May 12, 2025, and resurrects the most favored nation concept first introduced in 2020. The policy seeks to align domestic prices with the lowest rates paid by economically comparable countries while encouraging companies to raise prices abroad rather than rely on U.S. consumers to subsidize research costs.
Key elements of the new commitments include:
- Offering existing drugs to Medicaid beneficiaries at the lowest global “most favored nation” price.
- Guaranteeing that any future products will launch at or below those benchmark levels.
- Listing top-selling therapies on TrumpRx, a direct-to-consumer website scheduled to debut in January.
Several manufacturers previewed individual discount programs. Gilead announced a plan to make its hepatitis C regimen Epclusa available at a reduced price, while Sanofi disclosed discounts approaching 70 percent on multiple anti-infective, cardiovascular and diabetes treatments both on TrumpRx and other direct-purchase channels.
The agreements build on accords unveiled earlier this year with Eli Lilly, Novo Nordisk, Pfizer, AstraZeneca and EMD Serono, which similarly exchanged lower prices and direct sales options for exemption from forthcoming tariffs and faster regulatory review of new therapies.
U.S. prescription drug costs remain substantially higher than those abroad. A 2024 analysis by the RAND Corporation found that average prices were nearly three times those in 32 comparison countries, while branded medicines were priced at more than four times the overseas average.
Industry trade group PhRMA has argued that tying prices to foreign markets is ineffective and contends that pharmacy benefit managers, the intermediaries that negotiate rebates, drive much of the disparity. Nevertheless, the United States continues to be the most profitable market for global drugmakers; half of the ten largest European firms now generate a majority of their revenue in the U.S.
The White House indicated that compliance will be monitored through quarterly reporting. Companies failing to meet pricing or manufacturing milestones could see the tariff waiver revoked before the three-year period ends. Additional guidance on enforcement is expected from the Office of the United States Trade Representative and the Department of Health and Human Services later this year.
While consumer advocacy groups welcomed the prospect of immediate savings, several health-policy analysts cautioned that the long-term impact on innovation and global pricing structures remains uncertain. Congress, which has debated legislative approaches to drug costs for years, was not directly involved in the negotiated deals.
The administration plans to release a public database on TrumpRx that will display current retail prices, negotiated discounts and the applicable “most favored nation” rate for each participating product. Officials said the site will be updated monthly once it launches.
Crédito da imagem: Andrew Harnik / Associated Press
