Trump demands lower drug prices

President Donald Trump’s push to force lower U.S. drug prices took shape through a set of letters sent to 17 pharmaceutical companies on July 31, 2025, demanding action within 60 days, according to the White House. The letters told manufacturers to bring U.S. prices in line with the lowest price offered in other developed countries under a most-favored-nation, or MFN, framework. The White House said the companies were also warned that the government would use “every tool in our arsenal” if they did not comply. The campaign has since been folded into a broader administration effort spanning Medicaid, direct-to-consumer sales and proposed legislation. ### Which drug companies got the letters? The White House said letters were sent to AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, EMD Serono, Genentech, Gilead, GSK, Johnson & Johnson, Merck, Novartis, Novo Nordisk, Pfizer, Regeneron and Sanofi. The administration described them as leading pharmaceutical manufacturers and said the letters were part of Trump’s order to match prices paid in other wealthy countries. (whitehouse.gov) July 31, 2025, is the key date in the public record. A White House fact sheet published that day said Trump had sent the letters, and a White House release on August 4, 2025, said the companies had been given 60 days to lower prices for Americans. (whitehouse.gov) ### What exactly did Trump demand from the companies? The White House said the letters called on manufacturers to provide MFN prices to every Medicaid patient. The same fact sheet said companies were asked to guarantee that other developed nations would not get better prices on new drugs than the United States. (whitehouse.gov) The administration also said manufacturers were offered a path to sell medicines directly to patients, bypassing intermediaries, so long as the price was no higher than the best price available in developed nations. A separate provision said trade policy would be used to support higher prices abroad if the added overseas revenue was reinvested into lower prices for U.S. patients and taxpayers. (whitehouse.gov) ### Where did the MFN framework come from? Trump signed an executive order on May 12, 2025, directing agencies to pursue most-favored-nation prescription drug pricing for American patients, according to the White House. The order said Americans should not pay almost three times more for the same medicines than buyers in other developed countries. (whitehouse.gov) A White House research paper published on May 5, 2026, said the administration had since reached voluntary MFN pricing agreements with 17 of the world’s largest drugmakers. That paper said the framework covered both future drug launches and existing drugs, with new products to be launched in the United States at prices comparable to those in other high-income countries. (whitehouse.gov) ### How did the administration try to turn the letters into policy? HHS and CMS moved part of the agenda into Medicaid on November 6, 2025, when they announced the GENEROUS Medicaid Model. The agencies said participating state Medicaid programs would be able to buy included drugs at prices aligned with those in select other countries, with the model launching in 2026. (whitehouse.gov) Robert F. Kennedy Jr., the health secretary, said at the time that “By bringing most-favored-nation pricing to Medicaid, we’re driving down drug costs.” CMS Administrator Mehmet Oz said the pilot would help Medicaid programs pay what he called a fair and reasonable price. HHS said it would release a request for applications for drug manufacturers later that fall. (hhs.gov) ### How does direct purchasing fit into the strategy? HHS added a direct-sales piece on January 27, 2026, when it issued guidance on how drugmakers could sell lower-cost prescription drugs directly to patients, including Medicare and Medicaid enrollees paying cash, without automatically triggering anti-kickback concerns. The department said those sales could proceed if the drugs were not billed to federal programs and met other safeguards. (hhs.gov) The guidance linked that approach to the administration’s TrumpRx program. HHS said the direct-to-consumer channel was meant to expand access to lower-cost medicines while the Office of Inspector General sought additional public input on a possible formal safe harbor for those arrangements. ### What has the White House said happened next? (hhs.gov) The White House said on May 5, 2026, that the administration expected to work with Congress to codify the voluntary MFN agreements into law. The same paper projected $529 billion in 10-year domestic savings from prospective MFN pricing across all markets and $64.3 billion in federal and state savings over 10 years from applying MFN pricing to existing drugs in Medicaid. (hhs.gov) The next public milestones are tied to legislation and program rollout. The White House said Congress is being asked to codify the agreements, while CMS said the GENEROUS Medicaid Model is scheduled to launch in 2026 and HHS said TrumpRx-related direct-purchase policy remains under development through additional regulatory input. (whitehouse.gov)