Trump Strikes 9 New Pricing Agreements as Drugmakers Navigate Tariff, Regulatory Pressure

President Donald Trump has reached new pricing agreements with 9 major pharmaceutical companies—an effort aimed at narrowing the long-standing divide between American drug prices and those in Europe—according to reporting from The New York Times.¹ The deals mark one of the administration’s most sweeping attempts to pressure drugmakers into voluntary concessions rather than risk formal regulation.

The agreements require manufacturers to offer most of their drugs to Medicaid programs at the same prices charged in other wealthy countries, the Times reported. The companies also agreed to participate in a federal plan to steer Americans toward buying certain drugs directly from manufacturers through a forthcoming government website, TrumpRx.gov.

These agreements represent a partial realization of the goals outlined in Trump’s revived Most-Favored-Nation (MFN) effort announced earlier this year.² While the MFN order sought to mandate that drugmakers match the lowest prices offered in other developed nations—a plan that experts have said lacks crucial details³—the latest deals move in the same direction through voluntary commitments rather than sweeping regulation.

Recently, Lindsay Greenleaf, JD, MBA, head of policy, research, and analysis at ADVI Health, noted during an MJH Life Sciences^® webinar that if enough manufacturers continue striking voluntary pricing agreements with the administration, the 2 proposed MFN demonstration models, GLOBE and GUARD, might never be released because MFN pricing could be achieved without them.

The tariff exemptions offered in exchange for participation echo the administration’s earlier use of trade policy as leverage, underscoring how the pressure of the MFN agenda set the stage for the negotiated agreements now taking shape.

The 9 companies that joined the latest round of agreements are Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Roche’s Genentech unit, Gilead, GSK, Merck, Novartis, and Sanofi.¹ Their participation means that 14 out of 17 companies contacted by the administration over the summer have now signed on. Earlier deals had been announced with Pfizer, AstraZeneca, EMD Serono, Eli Lilly, and Novo Nordisk.

Three companies, AbbVie, Johnson & Johnson, and Regeneron, have not yet finalized agreements. Regeneron spokeswoman Alexandra Bowie told the Times that discussions with the administration remain ongoing.

Medicaid Pricing and Direct-to-Consumer Sales

A 2-track structure for the new agreements was outlined. First, the participating manufacturers will sell most of their drugs to Medicaid at prices comparable to European markets, where governments typically negotiate far more aggressively than the United States. Although Medicaid already receives the lowest domestic price available by law, officials told the newspaper that the new commitments could generate additional savings, particularly for drugs that historically cost more in the United States despite global parity elsewhere.

Second, the companies will create online storefronts that allow Americans to purchase certain medications directly, bypassing insurers. The Trump administration plans to launch TrumpRx.gov as a centralized portal that guides consumers to company-specific sites.

When a preview version of TrumpRx was posted earlier this fall, Robert Andrews, former US representative for New Jersey, and CEO of the Health Transformation Alliance, told The American Journal of Managed Care^® that "The symbolism here is very significant. The practical impact, I think, is much more limited."⁴

"The administration is saying to manufacturers, 'We’re no longer just going to say, ‘Well, drugs are expensive,’ and keep paying for them. We’re going to take a critical look at what drugs cost.' Second, they’re saying to the pharmacy benefit managers—the entities in the middle—implicitly, the administration is saying, 'We’re not sure you belong in the middle lane. We’re looking for ways that people can buy directly,'" Andrews explained in the interview.

In the latest deals, drugmakers also pledged that when they introduce new products into the US market, they will price them at levels aligned with what they intend to charge in Europe and other high-income countries, a notable shift in an industry long accustomed to launching products at substantially higher US list prices.¹

Incentives and Pressure Behind the Deals

In return for participating, companies will receive 3-year exemptions from any tariffs on imported pharmaceuticals that Trump may impose. The president has repeatedly threatened such tariffs as leverage but has not enacted them. According to the Times, avoiding those penalties has been a strong incentive, as has avoiding the possibility of strict regulation.

The administration’s push for voluntary deals has unfolded alongside work on potential drug-pricing regulations. This year, officials went through the procedural steps for new rules, including proposals related to Medicare drug spending and global price benchmarking. Notices showing the completion of key regulatory reviews were posted online this week, though no final rules have been unveiled.

Major Gaps Remain

Although the deals mark a significant development in Trump’s drug-pricing agenda, the Times emphasized what the agreements do not address: the high prices of many brand-name drugs purchased through private insurance or Medicare. Those costs continue to fall on employers, taxpayers, and patients through premiums and out-of-pocket spending. The voluntary agreements also fall short of imposing broad, enforceable price reductions across the industry.

Friday’s announcement represents one of the most expansive voluntary pricing efforts ever negotiated between the federal government and drugmakers. Whether these concessions will produce meaningful savings for patients—and whether companies still outside the agreement will eventually join—remains an open question.

References

1. Robbins R. Trump announces pricing deals with nine drugmakers. The New York Times. December 19, 2025. Accessed December 19, 2025. https://www.nytimes.com/2025/12/19/health/trump-drug-pricing-deals
2. Santoro C. Trump directs pharma companies on cutting drug prices under Most-Favored-Nation order. AJMC. July 31, 2025. Accessed December 19, 2025. https://www.ajmc.com/view/trump-directs-pharma-companies-on-cutting-drug-prices-under-most-favored-nation-order
3. Grossi G. Most Favored Nation drug pricing moves forward, but experts warn details are still missing. AJMC. November 5, 2025. Accessed December 19, 2025. https://www.ajmc.com/view/most-favored-nation-drug-pricing-moves-forward-but-experts-warn-details-are-still-missing
4. Steinzor P, Andrews R. TrumpRx signals limited impact, but a symbolic shift in drug pricing policy: Robert Andrews. AJMC. October 8, 2025. Accessed December 19, 2025. https://www.ajmc.com/view/trumprx-signals-limited-impact-but-a-symbolic-shift-in-drug-pricing-policy-robert-andrews