Trump Advances MFN Drug Pricing as Nine Global Pharma Giants Reach Landmark Agreement

U.S. President Donald Trump recently announced a new drug pricing agreement with nine leading pharmaceutical companies. The deal aligns U.S. prescription drug prices with the lowest levels paid by other developed countries. This approach follows the Most-Favored-Nation, or MFN, drug pricing principle. Participating companies include Amgen, Bristol Myers Squibb, Boehringer Ingelheim, and Genentech. Gilead Sciences, GSK, Merck, Novartis, and Sanofi also joined the agreement. Together, these firms represent a substantial share of global innovative drug portfolios.

High-Cost Medicines Included as Medicaid Stands to Benefit

The agreement covers high-cost therapies for chronic and complex diseases. These include treatments for diabetes, rheumatoid arthritis, multiple sclerosis, and respiratory diseases. It also includes therapies for hepatitis B and C, HIV, and selected cancers.

Under the agreement, Medicaid programs across all U.S. states can access MFN-level pricing. Officials expect the reform to save the federal government tens of billions of dollars. The policy reinforces Trump’s commitment to strengthening healthcare access for vulnerable populations.

The agreement also applies MFN pricing to all future innovative drugs from these companies. This provision aims to prevent foreign governments from free-riding on U.S. pharmaceutical innovation. Drugmakers must also reinvest overseas revenue gains back into benefits for U.S. patients.

TrumpRx Platform Promises Deep Discounts Through Direct-to-Patient Sales

The White House confirmed drugmakers will offer steep discounts through the TrumpRx direct sales platform. Prices will fall far below list prices once the platform launches in January 2026. Patients are expected to see immediate and meaningful reductions. Officials described these reductions as transformative for patient affordability.

• Amgen’s cholesterol drug Repatha will drop from $573 to $239.
  
• Bristol Myers Squibb’s HIV therapy Reyataz will fall from $1,449 to $217.
  
• Boehringer Ingelheim’s diabetes drug Jentadueto will decline from $525 to $55.
• Genentech’s influenza drug Xofluza will decrease from $168 to $50.
  
• Gilead’s hepatitis C therapy Epclusa will drop from $24,920 to $2,425.
  
• GSK will reduce prices across its asthma inhaler portfolio.
• Merck’s diabetes drug Januvia will decline from $330 to $100.
  
• Novartis’ multiple sclerosis therapy Mayzent will fall from $9,987 to $1,137.
  
• Sanofi’s Plavix will drop from $756 to $16 under TrumpRx. Sanofi will also cap monthly insulin prices at $35 through the platform. 

Manufacturing Investment and Supply Chain Resilience Take Center Stage

Participating companies pledged at least $150 billion for U.S. manufacturing expansion. The investment aims to strengthen domestic pharmaceutical supply chain resilience. It also supports Trump’s broader push for U.S.-based drug production. Several companies committed to donating active pharmaceutical ingredients to a national reserve. The Strategic Active Pharmaceutical Ingredients Reserve seeks to reduce foreign dependency. It also ensures stable supplies during public health emergencies.

• GSK donated nearly 99 kilograms of albuterol for emergency asthma treatments.

• Bristol Myers Squibb contributed apixaban tablets equivalent to 6.5 metric tons.

• Merck donated 3.5 metric tons of ertapenem for complex infection treatment.

A Policy Trump Calls Politically Impossible, Now Delivered

Trump emphasized the agreement fulfills his pledge to end global drug price subsidization. He argued Americans have long paid higher prices to support foreign healthcare systems. Previous administrations considered such reform politically unattainable.

Key Milestones in the MFN Drug Pricing Policy

• On May 12, 2025, Trump signed an executive order advancing MFN prescription drug pricing. The order directed agencies to align U.S. prices with comparable developed countries.
• On July 31, 2025, Trump formally urged major drugmakers to comply with MFN standards. 
• By September 30, 2025, agreements covered 14 pharmaceutical companies nationwide.
• On December 1, 2025, U.S. agencies reached a trade-linked agreement with the United Kingdom. The deal raised U.K. net prices for new drugs by 25 percent. Officials framed the move as ensuring fair payment for pharmaceutical innovation.

The agreement marked an extension of MFN policy through trade and interagency coordination. It aimed to rebalance global drug pricing and reduce America’s unilateral innovation burden.

Author

Steven Chung

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