The agreements are for so-called “most-favored-nation” prices, meaning that Medicaid will pay the same prices for drugs that other countries, primarily in Europe, pay. The Trump Administration also said that some most-favored-nation prices would be available on TrumpRx.gov, where patients can access drugs by paying cash rather than going through insurance.
The nine companies—Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals, and UCB—are in addition to the 17 drug companies that agreed to most-favored-nation deals at the end of 2025. The administration says that these deals cover 90% of the drugs used by Americans.
Lowering drug prices has been a top priority for the Trump Administration. Research from 2024 suggests that people in the U.S. pay 3-4 times what consumers in other countries pay for the same drugs.
On Sept. 30, 2025, Trump announced an agreement with Pfizer to bring most-favored-nation pricing to Medicaid; by the end of December, 13 other companies had agreed to deals.
Of course, it’s hard to know even how much the deal will save to Medicaid programs, he says. That’s because the terms of the deals are not publicly available, and neither are the prices Medicaid pays.
But those savings are likely only for the short term, says one of that study’s authors, Dr. Thomas Hwang, an assistant professor at Brigham and Women’s Hospital. “Long-term savings are likely illusory,” he says. That’s because evidence suggests that after most-favored-nation deals, companies often raise prices in other countries so that the prices that the U.S. compares its prices to will be higher.
“What you can be confident in is that the industry is going to do what it can to limit the impact through not only pricing, but delaying market entry in some other countries,” Gondi says.
There may be some other negatives to this deal, Hwang says. Some pharmaceutical companies have suggested in earnings reports that by agreeing to most-favored-nation prices with Medicaid, they won’t have to lower prices for drugs in Medicare, which is a much bigger program than Medicaid. That means that this voluntary agreement exempts pharmaceutical companies from what would have been a much more costly requirement. “That’s why I think this could be a bad deal for the government and taxpayers,” he says.
How could the administration lower drug prices for everyone?
The most-favored-nation announcement does not do much to address the root causes of why drug prices are so high in the United States, says Hwang. One way that drug companies keep prices high is by extending patents on blockbuster drugs, a method that is not available in many other countries. For instance, the patents for some GLP-1 medications expired in 2026 in India, China, and Brazil, allowing generic versions to be made.
If Medicare had broader authority to negotiate—say, the authority to talk with manufacturers at the beginning of a drug’s life cycle—prices for drugs through that program could drop significantly, says Hwang. But allowing Medicare to negotiate directly with drug companies would require an act of Congress, and might not be politically palatable at this time.
“I understand the Trump Administration’s push for most-favored-nation policies,” he says. “It’s an administratively easier pathway than lower drug prices for all payers.”
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