President Donald Trump unveiled agreements Friday with nine major drugmakers to cut prices on key medications, aligning U.S. costs with the lowest rates in other developed countries as part of his “Most Favored Nation” initiative.
The deals involve Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Gilead Sciences, GSK, Merck, Novartis, and Sanofi.
These companies produce treatments for conditions including cancer, diabetes, HIV, hepatitis, multiple sclerosis, autoimmune diseases, and respiratory issues, affecting hundreds of millions of Americans.
Trump described the pacts as a major step to stop U.S. patients from subsidizing cheaper drugs overseas.
“As of today, 14 out of the 17 largest pharmaceutical companies … have now agreed to drastically lower drug prices for … the American people and the American patients,” he said at the event. “This represents the greatest victory for patient affordability in the history of American health care, by far, and every single American will benefit.”
Under the voluntary arrangements, the firms will apply most-favored-nation pricing to existing drugs sold to Medicaid programs and commit to the same for future innovative medicines. They also pledged to repatriate additional foreign earnings from Trump’s trade policies to aid U.S. patients.
Specific reductions include Gilead’s Epclusa for hepatitis C, dropping from $24,920 to $2,425, Novartis’ Mayzent for multiple sclerosis, falling from $9,987 to $1,137, and Bristol Myers Squibb’s Reyataz for HIV, declining from $1,449 to $217. Sanofi will cap insulin at $35 monthly, while GSK’s Advair Diskus asthma inhaler will decrease from $265 to $89. Bristol Myers Squibb will provide its blood thinner Eliquis free to Medicaid recipients.
Several companies outlined expanded direct-to-consumer programs. Gilead plans a discount initiative for Epclusa; Sanofi will offer nearly 70% off drugs for infections, cardiovascular, and diabetic conditions; and Merck will provide about 70% reductions on diabetes treatments, including Januvia, Janumet, and Janumet XR, with potential extension to an experimental cholesterol drug. Amgen will broaden its offerings to include Aimovig for migraines at a 60% discount and Amjevita for autoimmune issues at 80%.
The agreements extend beyond pricing, with the nine committing over $150 billion to U.S. manufacturing and research. In return, they receive a three-year exemption from planned pharmaceutical tariffs, provided they boost domestic investments. Some will donate active pharmaceutical ingredients to a national stockpile that Trump established during his first term, including GSK’s 98.8 kilograms of albuterol for asthma inhalers and Bristol Myers Squibb’s 6.5 tons of blood-thinner components. The companies agreed to convert these into finished products if required.
A senior administration official noted the shift in industry response: “MFN has gone from a bold policy to an industry standard, and it’s happened in record time. What we’ve observed is initial industry hesitance collapsing into cooperation,” CNN reported.
These are the latest in a series of 14 deals secured since September, following Trump’s May executive order to match international prices and July letters to 17 CEOs demanding cuts. Earlier agreements included Pfizer, AstraZeneca, Eli Lilly, and Novo Nordisk, makers of weight-loss drugs like Wegovy and Zepbound, available at discounts as low as $149 monthly through direct channels, though not always covered by insurance for that use.
A separate December pact with the United Kingdom will raise drug prices there by 25%.
Johnson & Johnson, AbbVie, and Regeneron remain among the largest Pharmaceutical companies without deals, but Trump said Johnson & Johnson “will be here next week.”
Merck CEO Robert Davis endorsed the approach at the press conference: “I reflect on your goal of driving affordability and access to Americans, but equally, getting prices up outside the United States. And we’re 100% supportive of your actions.”
The initiative aims to address U.S. prescription prices that average nearly three times those abroad, with branded drugs over four times as costly, per a 2024 RAND Corporation study. The administration projects billions in Medicaid savings and an end to foreign nations’ “free ride on American innovation.”
Yet experts question the real impact, given the deals cover only a small fraction of available drugs and lack full details. Chris Meekins, managing director of health policy research at Raymond James, said companies participate because the concessions are “largely inconsequential” to profits, CNN reported. He added that the upcoming TrumpRx online platform, launching in January to connect cash-paying patients to discounted products, may help some, but likely not most Americans, who benefit more from insurance.
Industry group PhRMA argues most-favored-nation pricing isn’t ideal for reducing costs, pointing instead to pharmacy benefit managers as the cause of disparities. Many European drugmakers, despite having overseas bases, rely heavily on the U.S. market for most of their sales.
