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Trump Expands Most-Favored-Nation Drug Pricing Push to Nine More Manufacturers

The White House says the latest round brings 26 drugmakers under its pricing framework and could contribute to roughly $600 billion in projected savings over a decade, but key contract terms remain private and Teva says its agreement is still being negotiated.

September 15, 2026

President Donald Trump has announced another expansion of his administration's most-favored-nation drug-pricing strategy, saying nine additional pharmaceutical manufacturers will lower prices for state Medicaid programs and align future U.S. drug launches with prices available in other developed countries.

The White House on August 31 identified the companies as Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals, and UCB. It said the additions bring the total number of manufacturers covered by most-favored-nation arrangements to 26, representing 89% of the branded-drug market.

The central idea is to tie certain U.S. prices to lower prices available in comparable developed markets. Trump began the current push with a May 12, 2025 executive order directing federal agencies to pursue most-favored-nation pricing and to create pathways for direct purchases from manufacturers. On July 31, 2025, he sent letters to 17 leading drugmakers demanding Medicaid access to those prices, comparable treatment for future launches, and direct-to-patient options where appropriate.

The administration later announced a first agreement with Pfizer on September 30, 2025, followed by agreements with other large manufacturers. By April 2026, the White House said all 17 companies that had received the July letters had reached most-favored-nation arrangements. The August 31 round extends the strategy beyond the industry's largest companies and more deeply into midsize pharmaceutical and biotechnology firms.

At the Oval Office announcement, Trump said the new companies would offer their drugs to state Medicaid programs at most-favored-nation prices, calling the terms 'a tremendous discount' that should reduce medical costs. He also said new medicines covered by the arrangements would be offered to Americans at prices tied to the lowest levels available in other developed markets.

The White House said the latest arrangements involve treatments for hemophilia, Parkinson's disease, macular degeneration, glaucoma, liver disease, skin conditions and several forms of cancer. However, the administration did not publish the full contracts, detailed drug-by-drug price schedules, or a complete list of which existing products would receive what discounts.

That lack of disclosure is important. Reuters reported that the precise number of covered drugs, the size of individual discounts and the resulting savings for patients or government programs remain unclear because many deal terms are private. Several companies have also described portions of their agreements as confidential.

There is also a notable discrepancy involving Teva. The White House counted Teva among the nine companies with new agreements, but Teva said on August 31 that it remained in active discussions with the administration and announced an 'intent to reach agreement.' Teva said a final deal, if reached, would align Medicaid pricing for select medicines with prices in leading developed markets, include most-favored-nation treatment for applicable future innovative launches, support a reserve of certain active pharmaceutical ingredients and maintain U.S. manufacturing investment. The company said the negotiation conditions remain confidential.

Because of that discrepancy, the most precise description is that the White House announced nine new arrangements or commitments, while at least one named company - Teva - publicly said its final agreement had not yet been completed.

For Medicaid, the potential fiscal effect is different from a direct reduction in what most beneficiaries pay at the pharmacy counter. Medicaid already operates a federal drug rebate program that requires participating manufacturers to pay rebates to states and the federal government for covered outpatient drugs. For innovator drugs, federal law generally requires a basic rebate of at least 23.1% of average manufacturer price or the difference between average manufacturer price and the manufacturer's best price, with additional inflation-based rebates in many cases.

Medicaid beneficiaries also typically face limited prescription cost-sharing. That means a lower net price negotiated under the new framework could primarily reduce state and federal program spending rather than generate an equally large visible discount for an individual Medicaid patient. Whether the most-favored-nation terms outperform rebates already required under federal law will depend on the confidential pricing formulas and the drugs involved.

The administration nevertheless argues that the broader initiative can produce very large savings. The White House said the Council of Economic Advisers estimates total savings from Trump's most-favored-nation deals at roughly $600 billion over the next decade.

That figure should be understood as a projection, not money already saved. A White House economic analysis published in May estimated about $529 billion in domestic savings over 10 years from prospective most-favored-nation pricing across U.S. markets and another $64.3 billion in federal and state savings from making existing medicines available to Medicaid at most-favored-nation prices. Together, those estimates are roughly consistent with the administration's later $600 billion figure.

Reuters has cautioned that the savings estimates are speculative because they depend on assumptions about future drug launches, international prices, participation, utilization and how the private agreements are implemented. The full economic terms needed to independently reproduce many of the projections have not been publicly released.

The administration has paired the pricing initiative with which launched on February 5, 2026 as a direct-purchase and price-comparison channel for discounted medicines. The White House says patients have saved more than $700 million through TrumpRx since its launch, including savings on obesity and fertility drugs. That total is an administration figure and has not been accompanied by a public, drug-by-drug independent audit of the claimed savings.

The White House also says that in July 2026 seniors without existing GLP-1 coverage for obesity gained access to certain treatments for $50 per month. It reported that more than 500,000 seniors saved a combined $216 million during the program's first two months. At the August 31 event, Centers for Medicare & Medicaid Services Administrator Mehmet Oz said about 600,000 seniors had sought prescriptions through the temporary pilot, a different measure from the number the White House said had already realized savings.

Earlier agreements produced some of the administration's most visible announced price reductions for weight-loss medicines. Novo Nordisk and Eli Lilly agreed to lower certain prices in connection with expanded access through federal programs and direct-purchase channels. Reuters reported that weight-loss drugs have so far generated some of the largest identifiable savings under the initiative.

The August 31 package also includes a domestic-manufacturing component. The White House said the nine named manufacturers committed at least $19.6 billion collectively to near-term pharmaceutical manufacturing investment in the United States. The administration argues that the investments will increase domestic capacity, strengthen supply chains and reduce dependence on foreign production.

The announcement also ties drug pricing to pharmaceutical supply security. Several manufacturers committed active pharmaceutical ingredients to the Strategic Active Pharmaceutical Ingredients Reserve, or SAPIR, which is intended to preserve access to critical pharmaceutical inputs during emergencies or supply disruptions.

According to the White House, UCB will contribute 163 tons of levetiracetam, an anticonvulsant; Sun Pharma will contribute 71.4 tons of clindamycin and 6.75 tons of doxycycline, both antibiotics; Teva is listed as contributing 45 metric tons of metronidazole and 4.8 tons of amlodipine; and Astellas will contribute 25 kilograms of tacrolimus, an immunosuppressant used to prevent organ rejection. Teva's own statement, however, described its reserve commitment as part of a deal still under discussion, reinforcing the uncertainty over whether every element attributed to Teva was final on August 31.

The most-favored-nation strategy is built around the long-standing gap between U.S. and foreign prescription-drug prices. The administration and Reuters have cited evidence that American consumers often pay nearly three times what patients in other developed countries pay for the same medicines. Trump's May 2025 executive order argued that Americans were effectively subsidizing lower prices abroad and directed agencies to push manufacturers toward international price alignment.

Trump has repeatedly described the policy in sweeping terms. In December 2025, during an earlier round of agreements, he said, 'Starting next year, American drug prices will come down fast and furious.' At the August 31, 2026 event, he again claimed reductions of 50%, 60%, 70% and 80% for some medicines and said the initiative represented the largest reduction in prescription-drug prices in U.S. history. Those broader percentage claims do not apply uniformly to every medicine or every patient and depend on the specific product, payer and purchasing channel.

Critics say the administration has not provided enough public detail to demonstrate how widely the benefits will reach. Public Citizen's Peter Maybarduk called the new deals 'a distraction' from what the group considers an inadequate effort to bring U.S. prices fully into line with prices in other wealthy countries. Patients For Affordable Drugs also said the agreements remain difficult to evaluate because implementation and enforcement terms are not public and because Medicaid already receives substantial statutory discounts.

Supporters of the administration's approach point to a different set of measures: lower Medicaid net prices, direct-to-patient discounts, lower prices on some obesity medicines, commitments on future launch prices, domestic manufacturing investment and contributions to the national pharmaceutical reserve. From that perspective, the program is intended to reduce both health spending and supply-chain risk rather than operate as a single across-the-board retail price cut.

The distinction matters for patients. Someone covered by Medicaid may see little change in an already small prescription copayment even if the government pays much less for the medicine. A patient buying an eligible medicine through TrumpRx may see a more direct cash-price discount. A Medicare beneficiary in the temporary obesity-drug pilot may face a different benefit structure again. The practical effect therefore depends on the drug, the insurance program and the purchasing route.

It also matters for taxpayers. If the most-favored-nation prices negotiated with manufacturers are lower than the net prices Medicaid would otherwise obtain after statutory and supplemental rebates, states and the federal government could reduce spending. But without the full price terms, outsiders cannot yet calculate the incremental savings attributable specifically to the new nine-company round.

The same caution applies to the $19.6 billion manufacturing figure. The White House presents it as a collective near-term commitment linked to the agreements, but the timing, project scope and degree to which individual investments are new or previously planned can vary by company. The headline total is therefore useful as an administration benchmark but not a substitute for company-level capital-spending disclosures.

The August 31 announcement ultimately combines several policy goals that are related but not identical: international reference pricing, Medicaid spending, direct-to-consumer discounts, Medicare access to obesity drugs, domestic pharmaceutical manufacturing and emergency supply reserves. The administration presents those pieces as a single affordability and economic-security strategy.

For consumers, the most important unanswered questions are narrower: which specific medicines are covered, what price each medicine will carry, which patients qualify for the lower price, and whether the discount is larger than what their insurance or public program already provides. Those details will determine whether the latest agreements produce noticeable savings at the pharmacy counter or mainly lower government spending behind the scenes.

For now, the administration can point to a substantially larger roster of participating manufacturers and a framework that reaches most of the branded-drug market by its own estimate. But the scale of the ultimate savings - including the headline projection of roughly $600 billion over 10 years - will remain difficult to verify until more of the contracts, covered products and realized spending data become public.