The Trump administration said Aug. 31 that its most-favored-nation drug-pricing initiative now covers 26 pharmaceutical manufacturers, after nine additional companies signed on in a single week and pushed the program’s reach to roughly 89% of the U.S. branded drug market. The nine newest signatories are mid-sized specialty and generic drugmakers whose products treat hemophilia, Parkinson’s disease, glaucoma, liver disease and several forms of cancer, conditions that fall disproportionately on older patients. Under the pledge, each company agrees to tie its U.S. list price to the lowest price it charges in other wealthy countries, though the commitment remains a negotiated corporate agreement rather than a change to federal drug-pricing law.
Nine More Drugmakers Push Coverage to 89% of the Market
The newest group, Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals and UCB, joins 17 companies that had already signed most-favored-nation agreements, including Pfizer, Eli Lilly, Novo Nordisk, Merck, AbbVie and Johnson & Johnson. Together the 26 manufacturers now account for close to nine of every ten dollars spent on branded prescription drugs in the United States, the administration said.
The agreements extend most-favored-nation pricing to every state Medicaid program for products made by the nine newest companies, a group whose medicines address hemophilia, macular degeneration, glaucoma, liver disease, skin conditions and multiple forms of cancer, according to the fact sheet the White House released alongside the announcement. Medicaid is a primary coverage source for millions of low-income seniors who also qualify for Medicare, so a price cut that flows through state Medicaid formularies reaches a meaningfully older population even though the program itself is not Medicare-specific.
Each of the nine companies also agreed to guarantee most-favored-nation pricing on any new medicine it brings to market in the future, locking in the pricing structure beyond the drugs currently for sale. That forward-looking guarantee separates this round from a one-time discount: it applies to a company’s full future pipeline, not just its existing catalog of approved products.
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A Voluntary Pledge Backed by Tariffs, Not Statute
The most-favored-nation push began with a May 12, 2025, executive order directing the administration to bring U.S. prices in line with other developed nations, followed two months later by letters to 17 leading manufacturers outlining the terms they would need to accept. Pfizer signed the first agreement in September 2025, and nine more major manufacturers followed in a December 2025 batch before this week’s round of mid-sized companies closed out the list.
None of these deals rest on new legislation. They are negotiated commitments the administration secured company by company, using the threat of pharmaceutical tariffs and the leverage of Medicaid and Medicare purchasing as the incentive to sign. That structure means the pricing pledges could, in theory, unwind if a future administration drops the tariff threat or a company judges the trade-off no longer worthwhile, a risk that a price fixed in federal statute would not carry.
The nine newest signatories also committed to invest at least $19.6 billion collectively in U.S. manufacturing capacity in the near term, and several agreed to donate raw pharmaceutical ingredients to a federal stockpile called the Strategic Active Pharmaceutical Ingredients Reserve. UCB pledged 163 tons of the anticonvulsant levetiracetam, Sun Pharma committed antibiotic ingredients including clindamycin and doxycycline, Teva pledged the antibiotic metronidazole and the blood-pressure drug amlodipine, and Astellas pledged the transplant drug tacrolimus, according to the fact sheet.
TrumpRx and Medicaid: Where the Savings Numbers Actually Land
The administration points to two live programs as evidence the pricing deals are already producing consumer savings. Patients have saved more than $700 million on prescriptions through TrumpRx.gov since the discount portal launched in February 2026, and a July 2026 push to extend $50-per-month GLP-1 obesity-drug access to seniors without existing coverage reached more than 500,000 people who collectively saved $216 million in the program’s first two months, the White House said.
The Council of Economic Advisers separately estimates the full slate of most-favored-nation deals will produce $600 billion in savings over the next decade. That figure is the administration’s own internal projection rather than an outcome verified by the Government Accountability Office or an independent health economist, and it depends on assumptions about how broadly the 26 companies’ price cuts reach patients who are not enrolled in Medicaid or shopping directly through TrumpRx.
For retirees on Medicare Part D or a Medicare Advantage drug plan, the practical savings still depend on plan formularies and negotiated rebates that sit outside the most-favored-nation structure entirely; the deals govern list prices and Medicaid access, not what a specific Part D plan charges at the pharmacy counter. A senior taking one of the newly covered drugs for glaucoma or Parkinson’s disease would still need to check whether a lower list price has actually translated into a lower plan copay.
What remains unverified is how quickly, and how completely, a lower U.S. list price moves from a White House fact sheet into an individual pharmacy transaction. The administration has published two rounds of savings figures for TrumpRx and the GLP-1 program, but it has not yet released comparable transaction-level data tied to the nine companies added this week, leaving the size of this latest expansion’s real-world effect an open question.
This article was drafted with the assistance of AI and reviewed by The Money Overview’s editorial team before publication.
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