The Trump administration says 26 pharmaceutical manufacturers have now agreed to sell their drugs in the United States at the lowest price those same companies charge in other wealthy countries, after nine more companies signed on in late August 2026. The agreements, built around what the administration calls “most-favored-nation,” or MFN, pricing, now cover manufacturers representing 89% of the U.S. branded drug market, according to a White House fact sheet. For a retiree managing several prescriptions on a fixed income, the practical effect of any single deal depends on which drug is being taken, which manufacturer makes it, and whether it is bought through Medicare, Medicaid, or paid for in cash.
The Most-Favored-Nation Pricing Framework
The effort traces back to an executive order President Trump signed on May 12, 2025, titled “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” which directed federal agencies to work toward bringing U.S. drug prices in line with the lowest prices the same manufacturers charge in other developed nations, according to the order posted on whitehouse.gov. On July 31, 2025, the administration sent letters to 17 leading manufacturers outlining the steps needed to reach MFN pricing, and the first signed agreement, with Pfizer, followed on September 30, 2025. A December 1, 2025 side agreement with the United Kingdom raised the net price the UK pays for new drugs by 25%, part of the administration’s argument that other wealthy nations should stop what it calls “free-riding” on American drug development. Nine more manufacturer agreements were announced December 19, 2025, and the government launched TrumpRx.gov on February 5, 2026, as the site where cash-paying patients can act on the lower prices those deals produce.
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Nine More Companies, 26 Total, 89% of the Branded Market
The nine manufacturers added on August 31, 2026 are Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals, and UCB, joining a roster that already included Pfizer, Eli Lilly, Novo Nordisk, Amgen, Merck, Johnson & Johnson, AbbVie, Bristol Myers Squibb, and Sanofi, among others, according to the White House fact sheet announcing the round. The newest agreements apply to drugs treating hemophilia, Parkinson’s disease, macular degeneration, glaucoma, liver disease, skin conditions, and several forms of cancer, conditions common among older patients managing a chronic illness rather than a single daily prescription. The fact sheet also states the nine companies will give every state Medicaid program access to MFN pricing on their products, and that the manufacturers have committed to invest at least $19.6 billion in U.S. manufacturing, with several separately donating raw pharmaceutical ingredients, including an anticonvulsant and two antibiotics, to a federal strategic reserve intended to reduce reliance on foreign drug production.
How a Retiree Actually Sees the Lower Price
Because these are voluntary manufacturer agreements rather than a price-control law passed by Congress, the lower price is not automatically applied at every pharmacy counter for every patient. A consumer who wants to act on it directly can use TrumpRx.gov, the federal site that connects cash-paying patients to each manufacturer’s own discounted purchase program rather than functioning as an insurance plan or a pharmacy itself; a prescription from a licensed clinician is still required, and the lower price generally applies only when paying cash rather than billing insurance. Medicare and Medicaid access to MFN pricing runs through each program’s own coverage and payment rules rather than through TrumpRx directly. Whether a specific drug is covered by an agreement at all depends on whether its manufacturer is one of the 26 that has signed on — a list built in stages since 2025 that the administration has said it intends to keep expanding.
A $600 Billion Estimate, Not a Banked Result
The number attached to the deals’ long-term impact comes from the administration’s own economists, not an independent audit. The White House fact sheet states that “the Council of Economic Advisers estimates the total savings from President Trump’s MFN deals to reach $600 billion over the next decade,” a projection tied to the full set of 26 agreements and their eventual effect across Medicare, Medicaid, and cash-paying patients, not a savings total that has already materialized. The administration has separately said patients have saved more than $700 million through TrumpRx since its February 2026 launch, a figure describing money already spent and saved rather than a decade-long projection. President Trump has also asked Congress to pass a broader package, which the White House calls the Great Healthcare Plan, that would go beyond the voluntary manufacturer agreements now in place. Until Congress acts, the current MFN prices rest on the agreements the 26 companies have individually signed, and a retiree taking a drug from a manufacturer outside that list would not see a lower price under this program.
This Is Not the First Time Washington Has Tried This
The current round of agreements is not the first attempt at most-favored-nation drug pricing. During Trump’s first term, CMS issued a rule on November 27, 2020, tying Medicare Part B reimbursement for certain physician-administered drugs to the lowest price paid by a group of wealthy countries. PhRMA sued within weeks, and by the end of December 2020 federal judges in Maryland and California had blocked the rule for skipping the public notice-and-comment process required before it took effect, according to a summary of the litigation drawn from contemporaneous reporting; the incoming Biden administration withdrew the rule in 2021. The current program is built differently, as voluntary manufacturer agreements rather than a binding regulation, specifically to sidestep that legal vulnerability — though it also means no company is required to sign on, or to keep its commitment once signed.
Health policy analysts covering the newest round of deals have raised a separate, structural question about where the savings land. According to STAT News, the nine-manufacturer agreements announced August 31 chiefly apply to Medicaid, which by law already pays the lowest price of any major U.S. payer, while leaving companies exempt from mandatory price cuts in Medicare, the program covering the large majority of retirees. That combination, analysts told STAT, means the newest deals may do little to move prices for the Medicare population even as the administration counts them toward the same expanding total. PhRMA has separately estimated a broader, mandatory version of MFN pricing could cost manufacturers roughly $1 trillion over a decade and warned pricing tied to what other countries pay could slow new-drug development, an argument the administration disputes.
This article was produced with the assistance of AI and reviewed by The Financial Wire editorial team.
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Warren Cohen is a finance writer based in Phoenix, Arizona, covering personal finance topics including credit, banking, and beginner investing. He earned his degree in business administration from Arizona State University and began his career working in consumer finance, where he gained direct experience with lending and credit systems. He now writes for personal finance websites and fintech platforms, focusing on clear, practical content that helps readers make informed financial decisions.
