Several of the largest U.S. and European-based pharmaceutical companies entered into agreements with President Donald Trump on Friday to voluntarily reduce the prices of their medications, as his administration advocates for aligning domestic drug prices with lower prices available internationally. That includes Merck, Bristol Myers Squibb, Amgen, Gilead, GSK, Sanofi, Roche’s Genentech, privately-held Boehringer Ingelheim, and Novartis. The companies have consented to a three-year grace period during which their products will be exempt from the pharmaceutical-specific tariffs proposed by Trump, contingent upon the drugmakers making additional investments in U.S. manufacturing. One of the most significant commitments announced on Friday is that Bristol Myers Squibb will provide Eliquis, its leading blood thinner and most prescribed product, at no cost to Medicaid. The firms constitute the bulk of the 17 pharmaceutical manufacturers to whom Trump dispatched letters in July, urging them to reduce prices in alignment with his “most favored nation” policy. In May, Trump enacted an executive order aimed at reinstating that policy, advocating for price increases beyond U.S. borders and seeking to “end global freeloading.”

“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 stated during an event on Friday. “This signifies the most significant achievement for patient affordability in the annals of American health care, and every American will reap the benefits.” Johnson & Johnson, AbbVie, and Regeneron represent the last of the major firms that have yet to engage in drug pricing agreements. However, Trump remarked that Johnson & Johnson “will be here next week.” The complete details of the agreements have not been disclosed at this time, leaving ambiguity regarding the extent of their potential impact. The nine pharmaceutical companies have consented to implement strategies aimed at lowering drug prices in the United States. This includes offering their current treatments to Medicaid patients at the lowest “most favored nation” prices and ensuring that pricing for new medications is consistent with these commitments. Trump stated that the pharmaceutical companies have also consented to feature their most sought-after medications on his forthcoming direct-to-consumer platform, TrumpRx, set to debut in January.

Several companies have introduced new or enhanced direct-to-consumer offerings for specific pharmaceuticals. Gilead announced a program aimed at facilitating patient access to its hepatitis C treatment and cure, Epclusa, at a reduced price. Sanofi announced it will provide discounts approaching 70% on specific medications aimed at treating infections, as well as cardiovascular and diabetic conditions, available through TrumpRx and other direct-to-consumer platforms. Merck announced that it will provide three diabetes medications, Januvia, Janumet, and Janumet XR, at an approximate 70% discount for cash-paying patients via a direct-to-patient program. The company has indicated that the program will be extended to its experimental daily cholesterol pill, contingent upon its approval in the U.S. “I reflect on your goal of driving affordability and access to Americans, but equally, getting prices up outside the United States,” stated Robert Davis. “We fully endorse your actions.” In the interim, Amgen is set to broaden its current direct-to-patient initiative to encompass the preventative migraine medication Aimovig and the autoimmune treatment Amjevita, offering them at discounted monthly prices of 60% and 80%, respectively.

Earlier this year, Trump announced agreements with Eli Lilly, Novo Nordisk, Pfizer, AstraZeneca, and EMD Serono to sell certain drugs directly to patients at a discount, in exchange for exemptions from his planned pharmaceutical tariffs and other benefits, such as fast-tracked reviews of new drugs. According to a 2024 study, the average prices of prescription drugs in the U.S. are nearly three times higher than those found in other countries. The report indicated that prices for branded drugs exceeded those of their generic counterparts by a factor of more than four. In May, Trump enacted an executive order aimed at reinstating the most favored nation policy, which mandates price increases for goods sold outside the U.S. and seeks to “end global freeloading.” PhRMA has asserted that most-favored nation pricing is not the optimal approach to reduce drug costs for Americans. Instead, the organization has attributed the price disparity to pharmacy benefit managers. The United States stands as the preeminent market for numerous pharmaceutical companies, irrespective of their country of origin. European pharmaceutical firms, despite their transatlantic base, exhibit significant exposure to the U.S. market. Notably, half of the ten largest companies in Europe derive a substantial portion of their sales from the United States.