A Council of Economic Advisers projection sets the ten-year savings from the administration’s most-favored-nation drug agreements at $600 billion, a figure the White House published and attributed to its own economists. The number appears in a fact sheet dated September 18, 2026, and it is a projection of future savings, not money already saved or booked by any program.
The same sheet reports a separate and much smaller Council of Economic Advisers estimate for taxpayers and one realised figure for patients, and the three numbers measure different things. Keeping them apart is most of what the document supports.
A Council of Economic Advisers estimate, not booked savings
The fact sheet states that the Council of Economic Advisers estimates total savings from the most-favored-nation deals will reach $600 billion over the next decade. The wording is forward-looking: “will reach” and “over the next decade” mark it as an estimate for the period ahead, published on September 18, 2026. The figure is therefore the administration’s own analysis, carried on a White House document, and the sheet cites no outside scorer or independent review.
The sheet publishes no methodology for the $600 billion. It does not say which drugs, which programs or which payers the total covers, what price baseline it uses, or how many of the 26 participating manufacturers’ products are included. Without those details the figure cannot be checked against actual spending, and no agency source read for this article reports savings at that scale as realised.
The $64.3 billion taxpayer figure for Medicaid
A narrower estimate sits in the same document. The Council of Economic Advisers estimates that taxpayers will save $64.3 billion over the next decade in Medicaid drug costs across all 50 states, with $36.6 billion going to the federal government and $27.6 billion to state governments. This is also a projection, and it covers only Medicaid drug costs, where the $600 billion is described as total savings from the deals.
The sheet does not reconcile the two numbers or say what accounts for the difference. Whether the $600 billion includes the Medicaid savings, or measures savings at list prices, to patients, to insurers or to all of those together, is not stated. A reader comparing the two should treat them as separate estimates from the same author, not as a total and a share of it.
The $700 million that has already happened
The one figure in the document that describes a past result is the patient savings number: more than $700 million saved on medicines through TrumpRx.gov since its February 2026 launch. That is a cumulative total since launch, and the White House presents it as savings already achieved by patients.
TrumpRx.gov describes itself as a platform delivering “the lowest prescription prices in the world for Americans” built on most-favored-nation pricing, and it lets visitors search for medicines by zip code. The $700 million is a retail-channel number, and the sheet does not tie it to the $600 billion projection or to the Medicaid savings.
How the deals are meant to produce savings
The Medicaid portion runs through the GENEROUS Medicaid Payment Model, in which participating manufacturers pay state Medicaid rebates on expensive brand-name drugs so that final prices do not exceed most-favored-nation prices. The model is voluntary for states. HHS gave the starting point when it announced the model: Medicaid prescription drug spending of more than $100 billion in 2024, or $60 billion after existing rebates.
CMS Administrator Dr. Mehmet Oz said the model “will help ensure state Medicaid programs are paying a fair and reasonable price for prescription drugs,” and CMS Innovation Center Director Abe Sutton said it aims to put Medicaid pricing on par with other developed nations. Neither statement, as quoted by HHS, puts a dollar figure on savings, so the quotes describe intent and not results.
The sheet counts 26 manufacturers with agreements as of September 18, 2026, covering 89 percent of the branded drug market. The first agreement, with Pfizer, was announced on September 30, 2025, and the most recent batch of nine additional agreements on August 31, 2026. Each date comes from the sheet’s own timeline, which also lists the May 12, 2025 executive order that began the effort and the February 5, 2026 launch of TrumpRx.gov.
What a ten-year projection can and cannot carry
A decade-long estimate depends on assumptions the document does not list: how many states join a voluntary model, how long manufacturers keep their agreements, and how prices and drug volumes move. The projection stands as the Council of Economic Advisers’ calculation, dated September 18, 2026, and the fact sheet is the only source read for this article that contains it.
The firmest statements in the record are therefore narrow ones: the Council of Economic Advisers estimates $600 billion in total savings over the next decade, estimates $64.3 billion in taxpayer Medicaid savings over the same period, and the White House reports more than $700 million in patient savings through TrumpRx.gov since February 2026.
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AI tools assisted in drafting this report, and its figures were matched to the White House and HHS sources linked above.
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.
