In a move that could reshape the American pharmaceutical landscape, AstraZeneca has agreed to lower prescription drug prices for Medicaid and participate in a new federal marketplace, TrumpRx, following a high-stakes negotiation with President Donald Trump and his administration. The deal, announced on October 10, 2025, in the Oval Office, positions AstraZeneca as the second major drug manufacturer—after Pfizer—to strike such an agreement, aiming to bring U.S. drug prices closer to those paid in other developed nations.
President Trump, flanked by AstraZeneca CEO Pascal Soriot and Health and Human Services Secretary Robert F. Kennedy Jr., heralded the deal as a historic achievement. "For many years, Americans have paid the highest prices in the world for prescription drugs, by far," Trump declared, according to the Associated Press. "That’s what we get. The lowest price anywhere in the world." The centerpiece of the agreement is a "most-favored-nation" pricing model, which means Medicaid will pay no more than the lowest price AstraZeneca offers in any other developed country.
But the deal’s impact extends beyond Medicaid. AstraZeneca will also offer discounts of up to 80% off the list price for some drugs sold directly to consumers through TrumpRx, a government-run website set to launch in January 2026. The administration says this direct-to-consumer marketplace, where both AstraZeneca and Pfizer will participate, is designed to bypass traditional insurance and bring deep savings to Americans who often struggle with high drug costs.
Trump, never one to shy away from bold claims, told reporters that U.S. consumers could see “impossible discounts,” even quipping that inhalers for asthma would be discounted by 654 percent—a figure that, while mathematically perplexing, underscored his administration’s determination to drive prices down. He also cited the threat of steep tariffs as the key leverage that brought pharmaceutical giants to the negotiating table. "The tariffs were a big reason he came here," Trump said of Soriot during the Oval Office announcement, a sentiment Soriot echoed, acknowledging that a three-year tariff exemption was granted in exchange for AstraZeneca’s commitments.
The Trump administration’s aggressive stance on pharmaceutical tariffs began in earnest in September, when Trump threatened to impose a 100-percent tariff on imported drugs unless companies ramped up U.S. manufacturing. The tariffs were scheduled to take effect on October 1, 2025, but Pfizer’s last-minute deal on September 30 and AstraZeneca’s subsequent agreement led to their postponement. As Health and Human Services Secretary Robert F. Kennedy Jr. put it, “The president saw something that we didn’t see, which is we had leverage, and that came through Howard [Lutnick] and the tariffs.”
For AstraZeneca, the deal is not just about pricing. The company, based in Cambridge, United Kingdom, announced it will invest $50 billion in U.S. drug manufacturing and research by 2030, with the goal of reaching $80 billion in total revenue by then—half of it generated in the United States. The company’s drugs, which include treatments for cancer and chronic diseases such as lung cancer drug Tagrisso, ovarian cancer oral therapy Lynparza, and leukemia treatment Calquence, brought in more than $7.5 billion in U.S. sales last year alone.
One key part of AstraZeneca’s investment plan is a new $4.5 billion manufacturing plant near Charlottesville, Virginia, focusing on chronic diseases—a top priority for the Trump administration. Virginia’s Republican Governor Glenn Youngkin joined the Oval Office event to celebrate the groundbreaking, with Trump predicting the project could create 3,600 jobs domestically “just to begin with.” AstraZeneca’s investment in Virginia is part of a broader expansion, with the company also planning to bolster facilities in California, Indiana, Maryland, Massachusetts, and Texas.
The TrumpRx website, which currently features a "Coming Soon" message and prominent images of Trump, is being developed by The National Design Studio, a new government web design hub led by Airbnb co-founder Joe Gebbia. When it launches in January 2026, the site will allow Americans to purchase discounted drugs directly from manufacturers, bypassing traditional insurance and, potentially, pharmacy benefit managers. While some consumer advocates have praised the move for its potential to cut costs, others have expressed concern that the onus for lower prices is being placed heavily on manufacturers, without sufficient policy safeguards to ensure broad and lasting affordability.
The deals with AstraZeneca and Pfizer are the result of months of mounting pressure from the Trump administration. After reviving the "most-favored-nation" policy by executive order in May 2025—an approach previously blocked by a federal judge during Trump’s first term—the administration sent letters to 17 pharmaceutical companies over the summer, warning them to lower prices voluntarily or face government action. Trump’s executive order called for all necessary steps to penalize countries or companies that, in his view, contributed to higher U.S. drug costs.
Despite the administration’s optimism, questions remain about the real-world impact of these deals. Medicaid beneficiaries already pay some of the lowest prices for drugs, and for many insured Americans, copays may still be more affordable than even discounted direct-to-consumer prices. The full details of the discounts, and which drugs will be included, have yet to be released. AstraZeneca has said that inhalers like Bevespi Aerosphere (for COPD) and Airsupra (for asthma) will be among those available at a discount, but the scope of the program is still being defined.
As for the political implications, Trump was quick to claim credit for the breakthrough, pointedly noting that Democrats "shouldn’t get credit," despite one of AstraZeneca’s drugs already being subject to Medicare price reductions under President Biden’s administration. The White House has declined to comment on whether further deals with other pharmaceutical companies are imminent, but Trump has suggested that more announcements could be on the way, urging other drugmakers to "pick up a shovel," as Dr. Mehmet Oz, head of the Centers for Medicare and Medicaid Services, put it during the press conference.
For now, the pharmaceutical industry is watching closely. Pfizer’s CEO Albert Bourla welcomed the certainty and stability provided by the deal, which he said would help the industry recover from "historic lows" in valuation caused by tariff threats and pricing pressure. AstraZeneca’s Pascal Soriot, for his part, admitted the negotiations had "really kept me up at night," but ultimately described the agreement as a win for the company and for American consumers.
With the TrumpRx website still months from launch and the fine print of these sweeping changes yet to be fully revealed, Americans are left to wonder: will these deals truly deliver the lowest drug prices in the world, as promised? The answer will likely unfold in the coming year as the new marketplace takes shape and the pharmaceutical industry adapts to a rapidly changing regulatory environment.
