Overview
The administration has secured public commitments from 16 major pharmaceutical companies to bring U.S. prescription drug prices closer to the prices those firms charge in other developed countries. In return for those agreements the companies receive three-year exemptions from tariffs on drug imports. The drugmakers have accepted "most-favoured-nation" pricing commitments, agreed to sell medicines directly to consumers through a new government platform named TrumpRx.gov, and pledged billions of dollars of investment within the United States.
Letters sent by President Trump in July requested that leaders of 17 large pharmaceutical firms match U.S. prices on new drugs to the lowest prices available in other developed nations. Sixteen companies have publicly announced deals with the government; one, Regeneron, has indicated it expects to announce a deal in the near future and is the lone company among those contacted in July that has not yet signed.
Details of company commitments
Below are the public disclosures by each company that has announced a deal with the administration, with the companies listed alphabetically as they disclosed terms.
- Pfizer - In September Pfizer agreed to reduce prescription drug prices for American patients, including discounts of up to 85% through TrumpRx.gov. The company said the majority of its primary care treatments and certain branded medicines - specifically rheumatoid arthritis drug Xeljanz, dermatitis treatment Eucrisa and post-menopausal osteoporosis medicine Duavee - will be offered at average savings of 50%, with maximum savings reaching 85%.
- Johnson & Johnson - In January J&J agreed to lower drug prices for American patients, including via the TrumpRx.gov platform. The company did not disclose specific terms of the arrangement, nor did it identify revised prices or which individual medicines are covered.
- AstraZeneca - AstraZeneca agreed in October to lower prescription drug prices for U.S. patients, including discounts of up to 80% through TrumpRx.gov.
- Novo Nordisk - In November Novo Nordisk committed to reduce prices for its semaglutide medicines, including Wegovy and Ozempic, for U.S. patients across Medicare, Medicaid and a direct-to-patient cash channel. The company said prices for Ozempic and Wegovy will decline from $1,000 and $1,350 per month, respectively, to $350 when purchased through TrumpRx. Novo Nordisk also agreed to provide widely used insulin products, including NovoLog and Tresiba, at $35 per month through TrumpRx.
- Eli Lilly - Eli Lilly announced in November that it will offer Medicare beneficiaries its obesity medicines Zepbound and orforglipron (branded as Foundayo) at no more than $50 per month, and that additional discounts for self-pay patients will be available through LillyDirect. Lilly said the Zepbound multidose pen will be sold at $299 per month at the lowest dose, with higher-dose pens priced up to $449 per month; Foundayo will be available starting at $149 per month at its lowest dose through LillyDirect. Lilly also committed to offering the migraine treatment Emgality at $299 per pen, and the diabetes medicine Trulicity at $389 per month through TrumpRx.
- AbbVie - In January AbbVie agreed to lower drug prices through Medicaid and to expand direct-to-patient offerings via TrumpRx for medicines that include Humira and Synthroid.
- Bristol Myers Squibb - Bristol Myers Squibb said in December it will supply its blockbuster blood thinner Eliquis to Medicaid recipients for free under its agreement, and will donate more than seven tons of the active pharmaceutical ingredient used to make Eliquis.
- Gilead Sciences - Gilead stated in December that it will provide selected medicines used to treat HIV, hepatitis C, hepatitis B and COVID-19 at discounted prices for Medicaid beneficiaries. The company also agreed to set future medicines at price parity with other key developed nations and to make its hepatitis C treatment Epclusa available at a discounted cash price through TrumpRx and Gilead's own direct-to-patient program.
- EMD Serono (Merck KGaA unit) - In October the Merck KGaA unit EMD Serono said it would sell fertility treatments such as Gonal-f, Ovidrel and Cetrotide directly to consumers with a combined discount of 84% off list price if three of those medicines are used in an in vitro fertilization protocol. EMD Serono also committed to launching all new drugs in the U.S. at the same prices it charges in other developed countries.
- Merck - U.S.-based Merck announced in December plans to sell diabetes medicines Januvia, Janumet and Janumet XR directly to U.S. consumers at roughly 70% off list prices; those drugs are noted as facing generic competition next year. Merck also said that, if approved, its experimental cholesterol drug enlicitide will be offered through direct-to-consumer channels, including TrumpRx.
- Roche (Genentech) - Genentech, a unit of Roche, said in December it would lower prices for many of its medicines under Medicaid to levels comparable with those in other wealthy countries, and agreed to make its influenza medicines available via TrumpRx.gov and through its own direct-to-patient program.
- Novartis - Novartis indicated in December that it will introduce new drugs in the U.S. at prices comparable to those charged in other developed nations. The company also agreed to make multiple sclerosis medicine Mayzent and cancer drugs Rydapt and Tabrecta available through its direct-to-patient platform as well as through TrumpRx.gov.
- Amgen - Amgen said it would add cholesterol drug Repatha to its direct-to-patient program at a monthly price of $239, include migraine drug Aimovig and arthritis treatment Amjevita at $299 per month in that program, and that those offerings represent discounts of 60% to 80% off list price.
- Sanofi - Sanofi stated in December that it will offer lower-cost medicines via TrumpRx and other direct-to-patient channels, with average savings of around 70% for treatments addressing infections, heart disease and diabetes. Sanofi also agreed to align the Medicaid price of several medicines with prices in other high-income countries.
- GSK - GSK said in December it will make most of its inhaled respiratory medicines and other drugs available on a direct-to-patient platform with savings up to 66%. The company also agreed to reduce certain Medicaid prices and to pursue a more balanced pricing approach for new drug launches across developed countries.
- Boehringer Ingelheim - In December Boehringer Ingelheim said it would make its medicines available through TrumpRx.gov at discounted prices.
Regeneron - Regeneron said in April that it anticipates announcing a deal with the Trump administration "in the near future." It remains the sole company among the 17 that received letters in July that has not yet publicly signed an agreement.
Context and market implications
The publicly disclosed arrangements combine price concessions, direct-to-consumer sales channels and commitments to local investment. Companies have agreed to a range of measures, from steep list-price discounts through TrumpRx.gov and expanded direct-to-patient programs to aligning Medicaid prices and launching new drugs in the United States at parity with prices in other developed countries. Several of the commitments contain precise price points for specific medicines, while others describe broader programmatic adjustments without listing individual price changes.
These contracts touch multiple parts of the healthcare sector including manufacturers, payer programs such as Medicaid and Medicare, and the nascent federal direct-purchase channel represented by TrumpRx.gov. The agreements also have potential implications for drug import tariffs, manufacturer-marketing strategies and the configuration of direct-to-patient distribution.
Limitations and remaining items
While 16 companies have announced public deals, one recipient of the July letters, Regeneron, has stated only that an announcement is expected soon. Several companies disclosed specific medicines and exact price points; others described their commitments in more general terms or did not disclose which drugs would be covered. The level of public detail therefore varies across the announced agreements.