Twenty-six pharmaceutical manufacturers now hold most-favored-nation pricing agreements with the federal government, covering 89 percent of the branded drug market, after nine additional companies signed on August 31, 2026. The nine newest signatories are mid-sized firms rather than the largest drugmakers already under contract, and the administration’s own account of the deal ties its explicit savings promise to state Medicaid programs rather than to Medicare Part D, where most retirees actually fill prescriptions. No effective date accompanies the announcement, and the newest agreements do not repeat a discount-through-TrumpRx requirement that an earlier round of nine companies accepted in December.
Alcon, Astellas and seven other mid-sized drugmakers complete the roster
The nine companies that signed on August 31 are Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals and UCB, according to the White House. Their agreements set prices in line with the lowest price a comparable developed nation pays for the same drug, the mechanism the administration calls most-favored-nation pricing. The products affected treat hemophilia, Parkinson’s disease, macular degeneration, glaucoma, liver disease, skin conditions and several forms of cancer, conditions that weigh heavily on people past 65. The White House describes the nine as mid-sized manufacturers, distinct from the larger companies that signed in earlier rounds, among them Pfizer, AstraZeneca, Amgen and Merck, dating back to September 2025.
The pace has been steady rather than sudden. President Trump signed an executive order in May 2025 directing the pricing push, sent pricing letters to major manufacturers that July, and announced the first agreement, with Pfizer, on September 30, 2025. A group of nine larger manufacturers, including Amgen, Bristol Myers Squibb and Sanofi, signed in December 2025 and committed to invest at least $150 billion in domestic manufacturing. The nine companies that joined in August 2026 committed far less, at least $19.6 billion collectively, a gap the White House attributes to their smaller size relative to the December group.
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The Medicaid savings language is explicit; Medicare Part D is not mentioned
The fact sheet’s specific savings claim is aimed at Medicaid, not Medicare. It states that every state Medicaid program gets access to MFN drug prices on products made by the nine companies, language nearly identical to the wording used in December’s announcement for the earlier group of nine. Medicaid covers long-term nursing home care and, for people dually eligible for both programs, a share of prescription costs. The fact sheet contains no comparable sentence tying the new manufacturers’ MFN prices to Medicare Part D, the program that covers outpatient prescriptions for most enrollees 65 and older.
Some drugs made by the nine new companies may still reach older Americans at a lower price through TrumpRx.gov, the direct-to-consumer discount site the administration launched in February 2026 with the first five manufacturers to reach MFN deals. Since that launch, the administration says patients have saved more than $700 million on medicines purchased through the site, and a separate $50-a-month GLP-1 obesity-drug program for seniors launched in July 2026 produced $216 million in savings for more than 500,000 people in its first two months. Whether products from Alcon, Astellas, BeOne, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva or UCB will be added to TrumpRx, and on what timeline, is not addressed in the August 31 fact sheet.
That silence is notable next to December’s announcement, which explicitly required its nine signatories to offer TrumpRx discounts and to repatriate increased foreign revenue for the benefit of American patients. The August fact sheet lists no equivalent requirement for the newest nine, only that they will extend MFN pricing to Medicaid and honor MFN terms on future new medicines. Whether that omission reflects a different deal structure or simply a shorter public summary is not stated.
No effective date, and a voluntary framework instead of a regulation
The agreements are described throughout the fact sheet as commitments the manufacturers made to the administration, not a regulation, statute or price-control mechanism carrying a compliance deadline. No date appears anywhere in the document for when the nine newest companies’ negotiated prices take effect at a pharmacy counter, on TrumpRx, or through a state Medicaid program. Congress has not enacted the pricing framework into law; the fact sheet notes that the administration is calling on lawmakers to pass the Great Healthcare Plan, a broader package that would need separate legislative action to codify the MFN savings permanently.
The Council of Economic Advisers, a White House office, estimates the MFN deals will produce $600 billion in savings over the next decade, a figure built from the administration’s own research rather than an independent or peer-reviewed analysis. The fact sheet does not break out how much of that projected total depends on the nine companies added in August specifically, or over what years the savings are expected to accumulate.
The nine newest manufacturers also agreed to contribute raw drug ingredients to the Strategic Active Pharmaceutical Ingredients Reserve, a federal stockpile meant to reduce dependence on foreign suppliers. UCB pledged 163 tons of the anticonvulsant levetiracetam; Sun Pharma pledged 71.4 tons of the antibiotic clindamycin and 6.75 tons of doxycycline; Teva pledged 45 metric tons of metronidazole and 4.8 tons of the blood-pressure drug amlodipine; and Astellas pledged 25 kilograms of the transplant drug tacrolimus. Those contributions strengthen the medical supply chain rather than lower any single patient’s bill, and the fact sheet presents the reserve pledges and the pricing commitments together without separating what each one accomplishes.
What remains unresolved is the gap between the headline figures (26 manufacturers, 89 percent of the branded market, $600 billion in projected savings) and the absence of an implementation date, a Medicare Part D reference, or a TrumpRx listing requirement for the nine companies that just joined. An older American taking a hemophilia, Parkinson’s or cancer drug made by one of the nine will not learn from this announcement alone whether, or when, that translates into a lower price at a pharmacy counter.
This article was produced with AI assistance and reviewed by The Money Overview editorial team.
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