White House to Announce Second Drug Pricing Deal as AstraZeneca Joins TrumpRx

AstraZeneca will sell lower-priced drugs on the TrumpRx platform, the White House is set to announce Friday, according to MSNBC,¹ joining Pfizer as the second large multinational pharmaceutical company to choose this voluntary route to compliance with the Most Favored Nation (MFN) executive order.² MSNBC reports that AstraZeneca CEO Pascal Soriot will appear in the Oval Office with President Donald J. Trump this afternoon to make the announcement.¹

The agreement will see certain AstraZeneca drugs sold on the forthcoming TrumpRx.com website for discounted prices in line with those paid by comparator nations, in accordance with the MFN order, which was planned to begin with voluntary agreements, spurred by letters from the White House to drugmakers, and then move to aggressive action as needed. Experts had predicted that some companies would choose the concessions rather than risking potentially harsher cuts via rulemaking, as well as noted the looming threat of tariffs on imported drugs as a potential leverage point.³

With the new agreement, UK-based AstraZeneca will apparently avoid these tariffs by agreeing to sell discounted drugs on the TrumpRx site next year, though it’s not yet clear which drugs will be offered or how steep the discounts will be. MSNBC reports that the company will also pledge to invest $50 billion in US-based drug manufacturing and research and development.¹

If the AstraZeneca deal follows the example of the Pfizer agreement, the company will sell its drugs to Medicaid for similar prices to those paid in Europe—a significant component of the MFN order. Medicaid patients would also be able to use TrumpRx, but the direct-sales site is designed for use without insurance. Complexities in the details of these deals mean that the real-world impact may be limited, some experts say.

Robert Andrews, CEO of the Health Transformation Alliance, told The American Journal of Managed Care^® that the TrumpRx site will be for patients paying out of pocket, not using their health insurance, so its use will be for cheaper generic drugs rather than high-priced specialty drugs.⁴ He also noted that Pfizer’s agreement to bring US prices in line with Europe’s prices applies only to new drugs not yet on the market. Still, Andrews said, the aggressive pursuit of lower prices is a symbolic shift that puts manufacturers and pharmacy benefit manufacturers on notice that the drug pricing status quo cannot continue.

A key aspect of the voluntary agreements with drugmakers is that they avoid the risk of inviting legal challenges by compelling price reductions through policymaking, which had doomed the initial iteration of MFN attempted by Trump in his first term. Panelists discussing the differences between the attempts on an MJH Life Sciences® webinar this week noted that the executive orders were similar, but the first MFN rule was limited to Medicare Part B—and eventually blocked by courts before implementation—whereas the current approach is broader and less formal.⁵

“What we’ve seen, what I’d say was the difference, is we tried the process,” said panelist Stephen Forster, JD, partner at the Health Care and Life Sciences Practice at Jones Day. “We knew it was going to be long-winded. We didn’t go through that process, ultimately lost in litigation, and now what we have is what some are saying is coercive and kind of chaotic—‘We're going to keep coming after you on these different vehicles.’ I think the takeaway here is the difference, primarily, is we've gone from just Part B to across the board.”

While details on specifics of AstraZeneca’s deal were sparse before the announcement, the company had indicated its willingness to play ball with the idea of MFN months ago. Soriot had said in late July—shortly after the White House letters were sent—that AstraZeneca would support the idea of “rebalancing” to cut pricing in the US and implement minor increases in Europe.⁶

References

1. Traylor J. Trump strikes drug-pricing deal with pharma giant AstraZeneca. MSNBC. October 10, 2025. Accessed October 10, 2025. https://www.msnbc.com/msnbc/news/trump-strikes-drug-pricing-deal-pharma-giant-astrazeneca-rcna236905

2. Joszt L. White House, Pfizer reach agreement on drug discounts; Trump announces TrumpRx. AJMC^®. September 30, 2025. Accessed October 10, 2025. https://www.ajmc.com/view/white-house-pfizer-reach-agreement-on-drug-discounts-trump-announces-trumprx

3. Bonavitacola J, Oubre K. Letters from White House could encourage some compliance with Most-Favored-Nation executive order, broad agreements unlikely: Q&A with Kathy Oubre, MS. AJMC. October 10, 2025. Accessed October 10, 2025. https://www.ajmc.com/view/letters-from-white-house-could-push-some-compliance-broad-agreements-unlikely-q-a-with-kathy-oubre-ms

4. Steinzor P, Andrews R. TrumpRx signals limited impact, but a symbolic shift in drug pricing policy: Robert Andrews. AJMC. October 8, 2025. Accessed October 10, 2025. https://www.ajmc.com/view/trumprx-signals-limited-impact-but-a-symbolic-shift-in-drug-pricing-policy-robert-andrews

5. McNulty R. A "One-two punch" to innovation? the Most Favored Nation order and broader US drug pricing reform. AJMC. October 10, 2025. Accessed October 10, 2025. https://www.ajmc.com/view/a-one-two-punch-to-innovation-the-most-favored-nation-order-and-broader-us-drug-pricing-reform

6. Aripaka P, Fick M. AstraZeneca seeks US drug price cuts amid expansion plans, strong demand. Reuters. July 29, 2025. Accessed October 10, 2025. https://www.reuters.com/business/healthcare-pharmaceuticals/astrazeneca-seeks-us-drug-price-cuts-amid-expansion-plans-strong-demand-2025-07-29/