The Trump administration has expanded its push to tie U.S. prescription drug prices to the lower rates paid by other wealthy countries, striking new agreements with nine additional pharmaceutical manufacturers that bring the total number of companies participating to 26. Under the arrangements, every state Medicaid program gains access to the same discounted prices those companies already extend to buyers in Europe and other peer countries, a shift that touches medicines used to treat conditions from hemophilia to Parkinson’s disease, macular degeneration, glaucoma, liver disease, and several forms of cancer.
What the newest round of deals covers
The nine companies that signed on August 31 \u2014 Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals, and UCB \u2014 bring the roster of manufacturers with so-called most-favored-nation, or MFN, agreements to 26, according to the White House fact sheet announcing the deal, covering 89 percent of the branded drug market. Those 26 now include large, familiar manufacturers such as Pfizer, Eli Lilly, Novo Nordisk, Merck, Novartis, Sanofi, Johnson & Johnson, and AbbVie, whose deals were struck between late 2025 and earlier this year, alongside the nine mid-sized firms added in August. Most of the newest participants are based abroad: of the nine companies added this round, all but BridgeBio are headquartered outside the United States, according to STAT News, which also reported that four of them, UCB, Sun Pharma, Teva, and Astellas, are together contributing roughly 290 metric tons of active pharmaceutical ingredients to the country’s strategic reserve. The fact sheet breaks part of that total down further: UCB alone accounts for 163 metric tons of the anti-seizure drug levetiracetam, while Sun Pharma is contributing more than 78 tons of two antibiotics used to treat bacterial infections. The reserve, known as the Strategic Active Pharmaceutical Ingredients Reserve, is meant to reduce U.S. dependence on foreign manufacturers for ingredients considered critical during a shortage, natural disaster, or public health emergency. Each manufacturer pledges to sell new medicines to U.S. patients at prices comparable to the lowest price it charges in peer countries and to offer state Medicaid programs those same MFN prices, a condition the fact sheet frames as preventing foreign price controls from \u201cfree-riding\u201d on American drug innovation going forward, since the pledge applies to new medicines each company brings to market rather than its existing catalog. That 89 percent figure describes market coverage in dollar terms, not a guarantee that every plan or patient sees the discount reflected in an out-of-pocket price, since Medicaid programs, private insurers, and pharmacy benefit managers all layer their own coverage and formulary rules on top of a manufacturer’s list price.
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A year and a half of deal-making, one company at a time
The August agreement is the latest step in a process that began in May 2025, when Trump signed an executive order titled \u201cDelivering Most-Favored-Nation Prescription Drug Pricing to American Patients,\u201d followed two months later by letters sent to 17 major manufacturers outlining the terms. The first deal, with Pfizer, was announced that September; nine more companies signed on in December; the TrumpRx.gov discount portal launched in February 2026; and the August round added the nine smaller manufacturers named above. In between, in December 2025, U.S. trade and health officials reached a separate agreement with the United Kingdom that will raise the price the UK pays for new prescription drugs by 25 percent, part of the administration’s broader argument that other wealthy countries have been underpaying for American-made medicines relative to the cost of developing them. The fact sheet reports that patients have saved more than $700 million through TrumpRx since its February launch, and that a separate program letting seniors without GLP-1 coverage access those obesity and diabetes medicines for $50 a month has produced $216 million in savings for roughly 500,000 seniors in its first two months. The White House Council of Economic Advisers projects the MFN deals could produce $600 billion in savings over the next decade, a forecast rather than a figure that has already been realized.
Why the full details remain hard to verify independently
Because the MFN arrangements are structured as voluntary agreements rather than formal regulations, the specific pricing formulas negotiated with each manufacturer have not been made fully public, which has become its own point of contention. Massachusetts Senator Elizabeth Warren has publicly demanded that the administration release the underlying contracts and has accused Health and Human Services Secretary Robert F. Kennedy Jr. of withholding them, according to STAT News reporting from September 16. Until those contract terms are public, the size of the discount any individual state Medicaid program, or any individual patient, actually receives on a given drug remains something outside auditors can only estimate from the administration’s own summary figures rather than verify line by line.
How Medicaid drug pricing connects to a Medicare drug bill
The new agreements apply to state Medicaid programs, not directly to Medicare Part D, but the same manufacturers also sit inside the pricing structure behind other federal discount efforts most retirees actually use to fill prescriptions. Because each Part D plan negotiates its own formulary and pricing separately from these manufacturer deals, a discount that shows up for a Medicaid enrollee does not automatically appear on a Medicare drug bill for the same medicine.
It is a 10-page kit covering 51 state Medicare cost-help packs and the new Part D out-of-pocket cap.
Compare formulary and out-of-pocket costs plan by plan in The Medicare Cost & Coverage Protection Kit.
This article was researched and drafted with the help of AI and reviewed by The Financial Wire editorial team before publication.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
