Pharmaceutical Policy in Motion Continued: The Trump Administration’s Second Wave of Drug Pricing Deals

While it has been a busy summer in the pharmaceutical and PBM industries, the Trump administration’s most-favored-nation (MFN) pricing agenda is moving into a second phase targeting mid-sized pharmaceutical manufacturers. Following the MFN pricing deal announcement with Regeneron, the last of President Trump’s original list of 17 manufacturers that received MFN demands, President Trump announced on Monday, August 31, 2026, deals with nine additional mid-sized manufacturers to lower prescription drug costs for Americans. The nine manufacturers are Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals, and UCB. Together, the 26 drugmakers cover 89% of the brand drug market.

Key Deal Terms

Like the first wave of pricing deals, the details of the new MFN agreements remain largely confidential. However, the announcement indicates that all nine manufacturers will offer their drugs to state Medicaid programs at a discounted rate, in line with prices offered in other developed nations (MFN prices), including through the GENEROUS (GENErating cost Reductions for U.S. Medicaid) framework. Based on currently available reporting, these MFN agreements appear to be specific to Medicaid and, unlike the first wave of MFN agreements, have not been described as including direct-to-consumer or other broader discount arrangements. The drugs, though not specifically identified, treat conditions such as hemophilia, Parkinson's disease, glaucoma, macular degeneration, and certain cancers.

The manufacturers also committed to (1) investing at least $19.6 billion collectively in U.S. manufacturing and research and development, and (2) donating certain ingredients to the Strategic Active Pharmaceutical Ingredients Reserve (SAPIR) to ensure adequate supply in the event of an emergency.

Although the Trump administration’s announcement does not expressly address the issue, the manufacturers’ press releases state that the companies will be exempt from future pricing mandates and/or potential Section 232 tariffs in exchange for their commitments. None of the announcements indicate which drugs will be discounted or the amount of those discounts. It is also unclear whether any of the drugs will be offered on TrumpRx.gov, President Trump’s direct-to-consumer prescription drug purchasing platform.

Looking Ahead

In advance of his keynote address at the Republican midterm convention in Dallas on September 9, 2026, Dr. Oz announced that there were more voluntary MFN deals in the pipeline. Without greater transparency into the pricing terms and operational mechanics of these MFN agreements, their ultimate impact on state Medicaid programs, commercial payors, PBMs, and patients remains uncertain. While prescription drug prices are reportedly at an all-time low, it is difficult to determine the extent to which these MFN agreements and TrumpRx.gov are driving those reductions, particularly given the concurrent effects of Medicare drug price negotiations under the Inflation Reduction Act and other market forces influencing drug pricing.

We will continue to monitor drug pricing policy and the Trump administration’s efforts to address prescription costs. 
 

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