Trump Administration announces nine new MFN drug pricing agreements

Nine additional pharmaceutical manufacturers have reached Most-Favored-Nation pricing agreements with the Trump Administration, expanding the initiative to 26 companies, with commitments covering Medicaid pricing, US manufacturing, and pharmaceutical supply.

The Baseline

• Nine additional pharmaceutical manufacturers have reached Most-Favored-Nation drug pricing agreements with the Trump Administration.
• The agreements include commitments covering Medicaid pricing, future medicines, US manufacturing, and pharmaceutical supply.
• According to the White House, the latest agreements bring the total number of participating manufacturers to 26, covering 89% of the US branded drug market.

The White House has announced nine additional agreements under the Trump Administration’s Most-Favored-Nation (MFN) drug pricing policy, extending the initiative to a group of mid-sized pharmaceutical manufacturers. The agreements provide State Medicaid programs with access to MFN prices, include pricing commitments for future medicines, and introduce additional US manufacturing and pharmaceutical supply commitments. According to the Administration, the latest agreements bring the total number of participating manufacturers to 26, representing 89% of the US branded drug market.

The agreements involve Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals, and UCB. According to the White House, the agreements apply to medicines used to treat conditions including hemophilia, Parkinson’s disease, macular degeneration, glaucoma, liver disease, skin conditions, and several forms of cancer.

Under the agreements, every State Medicaid program will have access to MFN prices for products made by the nine manufacturers. The companies have also made commitments concerning future innovative medicines, which the White House states will be subject to MFN pricing as part of its policy of linking US prices more closely to those available in other developed countries.

The agreements also include commitments relating to pharmaceutical manufacturing and supply. Collectively, the nine companies have committed at least $19.6 billion to US manufacturing in the near term.

Astellas, Sun Pharma, Teva and UCB will additionally contribute active pharmaceutical ingredients (APIs) to the Strategic Active Pharmaceutical Ingredients Reserve. UCB will provide 163 tons of levetiracetam; Sun Pharma will contribute 71.4 tons of clindamycin and 6.75 tons of doxycycline; Teva will provide 45 metric tons of metronidazole and 4.8 tons of amlodipine; and Astellas will contribute 25 kg of tacrolimus.

The latest agreements follow an Executive Order signed in May 2025 directing the Administration to pursue MFN prescription drug pricing and letters sent to 17 pharmaceutical manufacturers in July 2025 outlining its pricing objectives. The first agreement, with Pfizer, was announced in September 2025. The White House now reports agreements with all 17 manufacturers originally contacted, alongside the nine companies included in the latest announcement.

The White House also reported more than $700 million in patient savings through TrumpRx since its February 2026 launch. Separately, it reported that more than 500,000 seniors have collectively saved $216 million since July through a program providing access to GLP-1 medicines for obesity for $50 per month. The White House cited an estimate from the Council of Economic Advisers that the Administration’s MFN agreements could generate $600 billion in savings over the next decade.

Commenting on the latest announcement, Neil Grubert (Independent Global Market Access Consultant) described its timing as “significant” in relation to planned Section 232 pharmaceutical tariffs. He noted that five companies stated that Section 232 tariffs would be deferred, and six explicitly referred to participation in GENEROUS.

Commentators have also raised questions about how the agreements will operate in practice. Nerea Blanqué Catalina (Alira Health) highlighted uncertainty over which international prices will be referenced, how MFN prices will be calculated, which products and patient populations are included and the relationship between the agreements and tariff treatment.

“A press release is not an implementation manual,” she commented, adding that “pricing, tariffs, manufacturing, supply-chain resilience and market access can no longer be managed as separate strategies.”

The implications are also being considered in Europe. Alexander Natz (EUCOPE) observed that:

 “Pricing, market access, trade policy and decisions about where companies invest, research and manufacture are becoming increasingly interconnected.”

Natz argued that Europe therefore needs to consider both access and competitiveness, including “safeguarding sustainable patient access while maintaining the conditions that make Europe an attractive place to innovate, invest and manufacture.”