Trump Announces Pricing Deals With 9 Drugmakers, Expanding Most-Favored-Nation Drug Pricing Strategy

President Donald J. Trump has announced new voluntary pricing agreements with 9 major pharmaceutical manufacturers that considerably extended the administration's strategy to bring US prescription drug prices to the level of those in European countries. The deals, unveiled at the White House, aim to reduce drug costs for Medicaid beneficiaries and certain cash-paying patients by demanding that manufacturers who participate provide prices that are similar to those given in other wealthy countries.¹

The 9 companies participating in the latest round of deals are Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Genentech (Roche’s US unit), Gilead Sciences, GSK, Merck, Novartis, and Sanofi.¹ Through these additions, the Trump administration has accomplished deals with 14 out of 17 pharmaceutical companies that that received official letters in July urging them to lower prices. AbbVie, Johnson & Johnson, and Regeneron are either not yet participating or are still in negotiations.¹

Medicaid Pricing and Direct-to-Consumer Sales

According to the newly announced arrangements, the pharmaceutical companies that took part in the agreement consented to selling the majority of their products to the state Medicaid programs at prices that are equal to those offered in the European countries. Although Medicaid is already provided with a few of the lowest prices on the US market because of the rebate requirements stipulated by law, the officials of the administration have stated that the agreements will bring in more savings for a few selected drugs that are high cost.¹ The agreements also bind the drug manufacturers to introducing new drugs in the US at prices that are close to those in countries of similar economic status, thus helping to stop the occurrence of price differences at the time of product launch.¹

Besides Medicaid pricing provisions, the agreements highlight drug purchasing directly from consumers as the main point. Manufacturers will make certain medications available for cash purchase through their own online platforms, allowing patients to bypass insurance altogether. To support this process, the administration is planning to have a TrumpRx.gov site, which will be a federal platform guiding the patients to manufacturers’ direct-buy portals. Administration officials say the site is estimated to be up and running at its full capacity in January 2026.¹

Incentives for Manufacturer Participation

The pricing agreements are voluntary, and officials have admitted that the manufacturers seem to be, at least to some extent, driven by avoiding regulatory or trade penalties. Companies that chose to align their prices with the Most Favored Nation (MFN) were given a 3-year suspension of any tariff that might be imposed by the administration on the import of pharmaceuticals. President Trump has repeatedly threatened to enact such tariffs as a means of pressuring drugmakers to lower prices but has thus far refrained from doing so.¹

Scope and Limitations of the Agreements

Although administration officials described the deals as a major step toward lowering drug costs, experts have noted several limitations. The deals mainly impact the prices of drugs under Medicaid and those that are bought directly with cash; hence, the prices of drugs that are covered by private insurance plans and Medicare remain almost the same. Employers and consumers, therefore, continue to pay for these costs via premiums, taxes, and out-of-pocket expenses.¹

However, those in favor of the system claim that prices based on the MFN can lead the way via indirect pressures on wider markets simply by setting international price benchmarks and thus, by a smaller moderation of the US launch prices of manufacturers. Market analysts and experts in managed care have mentioned that the newest MFN agreements for high-cost drug classes, like GLP-1 receptor agonists, could mean that eventually manufacturers will choose more negotiations than a strict federal regulation.²

Looking Ahead

For pharmacists, the changing MFN structure offers both possibilities and uncertainties. Patient behavior may be impacted by a direct-to-consumer purchase via TrumpRx, especially among those without or with inadequate insurance, who are looking for the cheapest cash prices. Pharmacists may need to counsel patients on differences between traditional pharmacy dispensing, manufacturer direct sales, and insurance coverage implications. Additionally, changes in Medicaid pricing could influence reimbursement dynamics and formulary decision-making at the state level.³

The December 2025 agreements are among the major drug pricing changes made under the second term of President Trump. Although there are still questions about the lasting effect, implementation, and consequences for the market, the agreements highlight that the federal government is again focusing on using international price comparisons as a means of dealing with the issue of drug affordability in the US. For pharmacists and other health care professionals, understanding the structure and limitations of these agreements will be essential as the policy landscape continues to evolve.

REFERENCES

1. Robbins R. Trump Announces Pricing Deals With Nine Drugmakers. New York Times. Published December 19, 2025. Accessed December 19, 2025. https://www.nytimes.com/2025/12/19/health/trump-drug-pricing-deals.html?unlocked_article_code=1.908.c7vf.q2pEvHe0RjTn&smid=nytcore-ios-share

2. Academy of Managed Care Pharmacy. Federal Update: Trump Administration Announces Deal to Bring Most-Favored-Nation Pricing to GLP-1s. December 2025. Accessed December 19, 2025. https://www.amcp.org/letters-statements-analysis/federal-update-trump-administration-announces-deal-bring-most-favored-nation-pricing-glp-1s

3. The White House. Fact Sheet: President Donald J. Trump Announces Largest Developments to Date in Bringing Most-Favored-Nation Pricing to American Patients. Published December 19, 2025. Accessed December 19, 2025. https://www.whitehouse.gov/fact-sheets/2025/12/fact-sheet-president-donald-j-trump-announces-largest-developments-to-date-in-bringing-most-favored-nation-pricing-to-american-patients/