President Donald Trump announced deals with nine additional pharmaceutical companies on Monday, extending his Most Favored Nation drug pricing initiative to 26 total agreements and covering what the White House says is nearly 90 percent of the branded drug market in the United States.
Trump made the announcement from the Oval Office, flanked by executives from the nine companies: Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals, and UCB. The agreements guarantee that every state Medicaid program will have access to MFN drug prices on all nine companies’ products, and that any new innovative medicines the companies launch will carry MFN pricing from day one.
The deals also come with a collective $19.6 billion commitment to U.S. manufacturing investment and ingredient donations to the Strategic Active Pharmaceutical Ingredients Reserve, known as SAPIR, a stockpile designed to reduce American dependence on foreign drug supply chains.
Trump did not hide his satisfaction with the milestone. As Breitbart News reported, the president told those gathered in the Oval Office:
“I’m thrilled to announce a major expansion of one of our signature affordability initiatives, something that people have been trying to get for years, for decades, and I’m not even sure that other presidents tried.”
That line carries more weight than it might seem. The concept of Most Favored Nation pricing, tying what American patients pay to the lowest prices negotiated by other developed nations, has been discussed in Washington policy circles for years. Prior administrations studied it, floated executive orders around it, and ultimately left it on the shelf. Trump has now signed 26 such agreements since last fall.
The nine companies announced Monday bring the roster alongside 16 previously announced partners, including AstraZeneca, Eli Lilly, Novo Nordisk, Amgen, Bristol Myers Squibb, Johnson & Johnson, AbbVie, Merck, Novartis, and others. The most recent prior deal, with Regeneron, was struck in April. This latest batch of nine at once represents the largest single expansion of the program to date.
The White House projects the combined agreements will save Americans billions of dollars on drugs that treat hemophilia, Parkinson’s disease, macular degeneration, glaucoma, liver disease, skin conditions, and various forms of cancer, a list that touches millions of patients and some of the most expensive chronic conditions in American medicine.
Beyond pricing, the deals carry two additional commitments that deserve attention. First, the $19.6 billion in collective U.S. manufacturing investment. The White House framed this as part of a broader push to bring pharmaceutical production back to American soil, a goal that gained urgency during the COVID-19 pandemic, when supply-chain fragility became impossible to ignore.
Second, four of the nine companies pledged specific ingredient donations to SAPIR. UCB committed 163 tons of levetiracetam, an anticonvulsant used to control seizures. Sun Pharma will contribute 71.4 tons of clindamycin and 6.75 tons of doxycycline, both antibiotics. Teva Pharmaceuticals pledged 45 metric tons of metronidazole, an antibiotic and antiprotozoal, along with 4.8 tons of amlodipine, a blood pressure medication. Astellas will donate 25 kilograms of tacrolimus, an immunosuppressant critical for organ transplant patients.
These are not symbolic gestures. Antibiotics, anticonvulsants, and immunosuppressants are the kinds of drugs that vanish from pharmacy shelves during supply disruptions. A domestic reserve of active pharmaceutical ingredients gives the country a buffer that didn’t exist before.
The administration’s broader effort to lower prescription costs has extended beyond MFN deals. The TrumpRx prescription drug discount program has grown to cover more than 800 medications, offering another channel for patients seeking relief at the pharmacy counter.
The White House fact sheet tied to Monday’s announcement states that the agreements lower costs across a wide range of costly, chronic, and rare diseases. But several questions remain unanswered. The administration has not disclosed the specific dollar amounts of projected savings, only that the figure runs into the billions. Nor has it detailed which individual drugs or product lines from each of the nine companies fall under MFN pricing.
The enforcement mechanisms behind the agreements are also unspecified. Whether the $19.6 billion in manufacturing investment represents a legally binding commitment or a voluntary pledge is not addressed in the White House materials. And five of the nine companies, Alcon, BeOne Medicines, BridgeBio, CSL, and Kyowa Kirin, are not listed as contributing ingredients to SAPIR, leaving open whether those firms will make similar donations later.
These are fair questions. But they do not diminish the core achievement. Twenty-six pharmaceutical companies now operating under MFN pricing agreements, covering nearly nine in ten branded drugs sold in America, is a structural shift, not a press release.
The administration has faced resistance on other policy fronts, including a federal judge blocking Trump’s proposed $100,000 H-1B visa fee, a reminder that executive action often meets judicial friction. The drug pricing initiative, built on voluntary company agreements rather than regulation, has so far avoided that obstacle.
One detail in Monday’s announcement deserves particular emphasis. The agreements ensure that every state Medicaid program, not just some, not just those in states with political leverage, gets access to MFN pricing on these companies’ products. For lower-income Americans who depend on Medicaid, this is the difference between a policy talking point and a tangible benefit.
The guarantee also extends forward. Any new innovative medicine these nine companies bring to market will launch at MFN pricing. That provision closes a loophole that has plagued past drug pricing efforts: companies agreeing to lower prices on existing products while setting sky-high launch prices on new ones.
Elsewhere in the administration’s policy landscape, the Department of Justice has pursued settlements with major health institutions, including a recent agreement with the Cleveland Clinic on a separate matter, part of a pattern of using federal leverage to enforce policy priorities across the healthcare sector.
The White House’s claim that nearly 90 percent of the branded drug market now falls under MFN agreements is the number that matters most. The metric behind it, whether it refers to revenue, prescription volume, or number of distinct drugs, is not specified. But by any reasonable measure, the roster of 26 companies includes most of the dominant names in global pharmaceuticals.
AbbVie, Johnson & Johnson, Merck, Novartis, Eli Lilly, Novo Nordisk, AstraZeneca, Bristol Myers Squibb, Amgen, Sanofi, Gilead Sciences, GSK, Regeneron, Genentech, Boehringer Ingelheim, EMD Serono, and now Alcon, Astellas, BeOne, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva, and UCB. That is not a pilot program. It is a market-wide realignment.
Meanwhile, other federal developments continue to shape the political backdrop. A federal judge recently cleared the way for the release of Biden’s Special Counsel interview audio, keeping accountability questions from the prior administration in public view even as the current one stacks up policy wins.
For years, Americans watched their drug prices climb while patients in Canada, Europe, and Japan paid far less for the same medications made by the same companies. The MFN framework attacks that disparity directly: if a company sells a drug cheaper abroad, American patients get the same price.
Twenty-six companies have now agreed to those terms. The branded drug market is nearly covered. Billions in manufacturing investment are pledged. Critical pharmaceutical ingredients are flowing into a domestic reserve. And every new drug these companies launch will carry the lower price from the start.
Critics will note the open questions, the enforcement details, the binding nature of the pledges, the precise savings figures. Those concerns are worth tracking. But the trajectory is unmistakable, and it runs in one direction: toward lower prices for the people who actually pay for their prescriptions.
Washington spent decades talking about drug prices. This administration is closing deals.
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