Under President Trump, the administration has already delivered notable reductions in out-of-pocket costs for several prescription drugs, building on executive actions and voluntary agreements with pharmaceutical manufacturers.
These efforts focus on enforcing "most-favored-nation" (MFN) pricing—tying U.S. costs to the lowest rates in other developed countries—along with direct negotiations and tariff threats to compel compliance.
For instance, starting in September 2025, deals with Pfizer and AstraZeneca slashed prices on a range of high-demand medications, including statins for cholesterol and blood thinners, by up to 60-80% for Medicare and Medicaid patients, benefiting millions by aligning U.S. rates with those in Canada and Europe.
In November, agreements with Eli Lilly and Novo Nordisk further dropped costs for diabetes drugs like Ozempic and Wegovy—used for both diabetes and obesity—by an average of 50%, saving users hundreds per month and taxpayers billions annually, with these changes taking effect immediately for covered plans.
A May 2025 executive order kick-started this by setting price targets and authorizing the TrumpRx.gov platform, which launched in October 2025 to allow direct consumer purchases at MFN rates, bypassing middlemen and already enabling discounts on over 20 drugs for uninsured patients.
Additionally, a 100% tariff on imported branded drugs, announced in October 2025, has incentivized five major manufacturers to commit to U.S. price parity, averting supply disruptions while cutting costs on imported generics by 30-40%.
On insulin specifically, President Trump has preserved the $35 monthly cap for Medicare beneficiaries—originally advanced voluntarily under his first term for about 800,000 users—and extended similar low-cost access through federally qualified health centers, where prices for low-income patients have already fallen to as low as $0.03 per vial plus a small fee since April.
These steps, including site-neutral payments that equalize hospital and clinic drug reimbursements (saving up to 60% on administration costs), have already lowered Part B coinsurance for 50+ drugs by an average of $200-500 per treatment, with broader MFN rollout projected to save $85 billion over seven years without disrupting access.
This is not the first time Donald Trump has tried to tie drug prices to what other countries pay. During his first term, a court blocked a proposed international reference pricing program.
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