In a sweeping move that could reshape the landscape of American health care, President Donald Trump on Friday unveiled a series of agreements with nine of the world’s largest pharmaceutical companies to voluntarily lower drug prices in the United States. The announcement, made at a White House event on December 19, 2025, marks the most significant expansion of the administration’s ongoing campaign to bring U.S. drug costs in line with those paid by other wealthy nations, a goal that has long eluded policymakers and frustrated patients.
The companies signing onto the deals are a who’s who of the pharmaceutical industry: Merck, Bristol Myers Squibb, Amgen, Gilead Sciences, GlaxoSmithKline (GSK), Sanofi, Roche’s Genentech, Boehringer Ingelheim, and Novartis. Together, they represent a majority of the 17 drugmakers President Trump contacted in July as part of his revived "most favored nation" (MFN) policy, which seeks to end what he’s called "global freeloading" by aligning American drug prices with the lower rates charged abroad. According to NPR, these agreements now bring the total number of major companies on board to 14, with Johnson & Johnson expected to join soon.
“As of today, 14 out of the 17 largest pharmaceutical companies ... have now agreed to drastically lower drug prices for … the American people and the American patients,” Trump declared from the podium, according to Politico. “This represents the greatest victory for patient affordability in the history of American health care, by far, and every single American will benefit.”
The centerpiece of the deal is a three-year grace period during which the participating companies’ products will be exempt from the administration’s planned pharmaceutical tariffs—so long as they commit to further investments in U.S. manufacturing. As reported by NPR, the companies have pledged at least $150 billion in new manufacturing and research and development operations on American soil. There’s also a new strategic reserve of active pharmaceutical ingredients, designed to ensure domestic supply in emergencies, according to Politico.
For consumers, the most immediate impact may be felt through expanded direct-to-consumer programs and a new government website, TrumpRx.com (or TrumpRx.gov), set to launch in January 2026. This portal will allow patients—especially those paying cash—to access popular prescription drugs at sharply discounted prices. For example, Merck will reduce the price of its diabetes medication Januvia from $330 to $100 for those purchasing through TrumpRx, while Amgen will offer its cholesterol-lowering drug Repatha for $239, down from $573, as detailed by NPR.
Other companies are following suit: Gilead is launching a program to offer its hepatitis C treatment Epclusa at a discount, and Sanofi will provide nearly 70% discounts on select medications for infections, cardiovascular, and diabetic conditions. Merck, for its part, will also offer its diabetes drugs Janumet and Janumet XR at similar discounts, and has pledged to extend this to a new cholesterol pill if it gains U.S. approval. Amgen is expanding its direct-to-patient offerings to include preventative migraine medication Aimovig and autoimmune treatment Amjevita, at 60% and 80% discounts, respectively.
Perhaps most notably, Bristol Myers Squibb has pledged to offer its blockbuster blood thinner Eliquis—the company’s top-prescribed product—free to Medicaid patients. The agreements also require that existing treatments be sold to Medicaid at the lowest "most favored nation" prices, and that pricing for new medicines adhere to similar standards. According to Politico, the MFN price is determined by taking the second-lowest price paid in a group of countries including Canada, Denmark, France, Germany, Italy, Japan, Switzerland, and the United Kingdom, adjusted for income levels. The majority of each company’s drug portfolio will be offered at these MFN prices to Medicaid, though some details remain to be ironed out.
While the administration touts these deals as a watershed moment for affordability, the full impact on out-of-pocket costs for most Americans remains uncertain. As NPR points out, Medicaid and its beneficiaries already pay some of the lowest prices for prescription drugs, and many insured patients may find their copays are lower than the cash prices available through direct-to-consumer programs. Furthermore, as Politico notes, the TrumpRx discounts won’t count toward insurance deductibles, and it’s unclear how quickly the agreements will translate into savings for those with private insurance.
Still, the administration is framing the deals as a bold step toward breaking the cycle of high drug prices in America. Health and Human Services Secretary Robert F. Kennedy Jr. praised the agreements, saying, “Nobody has done anything for affordability greater than this.” Centers for Medicare and Medicaid Services Administrator Mehmet Oz echoed the sentiment, calling the deals a significant achievement for health care affordability.
The agreements also come at a politically charged moment. Congress recently failed to extend Affordable Care Act tax credits, which are set to expire at the end of the year, likely driving up insurance premiums for millions. According to The Wall Street Journal, top Republican pollsters have urged the president to highlight his efforts on drug pricing as a counter to Democratic attacks on health care affordability. Trump himself seized the opportunity at the White House event to threaten the health insurance industry, promising to call executives to Florida or Washington for talks on lowering premiums. “I’m going to call a meeting of the insurance companies. I’m going to see if they get their price down. To put it very bluntly,” he said, as quoted by NPR.
Not everyone is convinced the MFN approach is the best way to tackle high drug costs. The Pharmaceutical Research and Manufacturers of America (PhRMA), the industry’s main trade group, has criticized the policy, arguing that pharmacy benefit managers are to blame for much of the price disparity. Meanwhile, analysts like Chris Meekins, a former health official, caution that most consumers “are not going to see any benefit in their pocketbook from the MFN deals that have been negotiated.”
The deals also reflect the global nature of the pharmaceutical market. Despite being based in Europe, many of these companies generate the majority of their revenue from U.S. sales, making them especially sensitive to American policy shifts. The administration has used this leverage to push for both lower prices at home and higher prices abroad, with Trump warning that tariffs will be applied to countries that don’t agree to raise what their health systems pay for drugs.
While the fine print of the agreements is still being worked out—and questions remain about their durability after Trump leaves office—the scale of the commitments is hard to ignore. Over $150 billion in new investments, a new strategic reserve for emergencies, and the promise of lower prices for millions of Americans: it’s a bold bet on the power of negotiation and market pressure to deliver what years of legislative wrangling have not.
As the TrumpRx website prepares to launch and the pharmaceutical industry braces for further changes, Americans are left to wonder: will this be the long-awaited turning point on drug prices, or just another chapter in a saga that has frustrated patients and politicians alike for decades?
