Sixteen major drug companies signed agreements with the Trump administration over the past few months to bring down prescription costs for Americans. But every one of those companies has raised prices on at least some of their drugs set to take effect in 2026.
Background
The Trump administration started pushing drug companies hard in late 2025 to match U.S. prices to the lower rates paid in other rich countries. Officials called it most-favored-nation, or MFN, pricing. The idea was simple: why should Americans pay more when places like Canada or nations in Europe get the same medicines cheaper?
Deals began rolling out after September 30, 2025. First came agreements with companies like Pfizer, AstraZeneca, Eli Lilly, and Novo Nordisk. By mid-December, nine more joined: Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Gilead Sciences, GSK, Merck, Novartis, and Sanofi. Johnson & Johnson signed on recently, bringing the total to 15 out of 17 approached. AbbVie and Regeneron are the holdouts, but AbbVie announced its own deal this week.
In exchange, these companies got a three-year break from tariffs on imported drugs that the president has threatened but not yet put in place. The White House touted the pacts as a way to stop other countries from free-riding on U.S. innovation. They also set up TrumpRx.gov, a website to help people buy certain drugs directly at big discounts, skipping insurance middlemen.
The push fits into a bigger plan. President Trump has called on Congress to pass what he labels the Great Healthcare Plan. That would lock in these MFN deals into law. Meanwhile, separate efforts from the Inflation Reduction Act, passed under the prior administration, will lower prices on 10 high-cost Medicare drugs starting in 2026.
Key Details
The deals sound good on paper. Companies promised to sell drugs to state Medicaid programs at MFN prices, meaning rates no higher than the lowest in other developed nations. They also committed to launch new medicines at those same levels in the U.S. For direct sales, some gave examples of steep cuts. Bristol Myers Squibb said its HIV drug Reyataz would drop from $1,449 to $217 through TrumpRx. Boehringer Ingelheim's diabetes pill Jardiance went from $525 to $55. Novartis cut its multiple sclerosis treatment Mayzent from $9,987 to $1,137. Sanofi's blood thinner Plavix fell from $756 to $16.
GSK, Bristol Myers Squibb, and Merck even pledged to donate ingredients for key medicines to a national stockpile. Johnson & Johnson agreed to sell to Medicaid at European prices and join the TrumpRx platform.
But the fine print leaves gaps. Most deals stay private, so no one outside knows exactly which drugs qualify, how prices get calculated, or how deep the discounts really go. Medicaid already gets the lowest U.S. prices by law, so these MFN pledges might not save as much as hoped for existing drugs.
Price Hikes in Early 2026
Now the reality hits. In the first two weeks of 2026, prices rose on 872 brand-name drugs. More increases could come before January ends. All 16 deal-making companies took part in these hikes. Experts say the agreements focus on cash prices for select drugs and vague Medicaid promises. They leave most products alone, especially ones already on the market.
Dr. Ben Rome, a health policy researcher at Brigham and Women's Hospital, pointed out the limits.
"The deals were short on details and were limited. They mentioned cash prices for some drugs and some vague commitments for Medicaid discounts, something the program already gets. The bigger pledge was for future drugs being launched at the same price here as in other wealthy countries, but that leaves a lot of the companies' products untouched."
— Dr. Ben Rome
Joaquin Duato, head of Johnson & Johnson, praised the partnership after their deal.
"Today’s agreement shows that when the public and private sectors work together towards shared goals, we can deliver real results for patients and the US economy."
— Joaquin Duato, Johnson & Johnson CEO
What This Means
For patients, the mixed signals create confusion. Some will see real savings on TrumpRx for drugs like Reyataz or Jardiance if they buy direct. Medicaid users might pay less on covered products from these companies. Medicare beneficiaries get relief on those 10 negotiated drugs from the Inflation Reduction Act, saving $1.5 billion in out-of-pocket costs yearly.
But everyday price hikes hit hard. Families relying on brand-name medicines for diabetes, HIV, heart issues, or cancer face higher bills at the pharmacy. The deals cover only parts of each company's lineup. Older drugs, which make up most prescriptions, often stay out. With details hidden, it's hard to measure the full impact.
The administration keeps negotiating. A new deal with the United Kingdom raised drug prices there by 25% on fresh medicines, aiming to balance the load. More companies might sign on. Congress could act on the Great Healthcare Plan, making MFN rules permanent. Tariffs remain a stick if firms back out.
Patients watch and wait. Savings on a few drugs help, but broad hikes remind everyone that lowering U.S. drug costs stays a tough fight. The 16 deals mark progress, yet prices climb anyway into 2026.
