Every president since Bill Clinton has promised to do something about American drug prices. Every one of them gave the speech. None of them moved the needle, because Big Pharma is one of the most effective lobbying operations in Washington and both parties feed at the same trough.
Enter President Donald Trump, who is actually doing something about lowering prescription drug prices – for all Americans, regardless of party. On Monday, Trump added nine more manufacturers to his Most-Favored-Nation pricing agreements. That brings the total to 26 companies covering 89 percent of the branded drug market — or, as HHS Secretary Robert F. Kennedy Jr. put it, nine out of every ten drugs Americans actually take.
.@POTUS announces a major expansion of his Most Favored Nation drug pricing initiative — with nine new pharmaceutical companies committing to deliver their lowest drug prices for American patients. pic.twitter.com/hNoPACjnVk
— Rapid Response 47 (@RapidResponse47) August 31, 2026
The premise is simple enough that its absence from American policy for three decades is the scandal. U.S. patients pay roughly three times what patients in other developed countries pay for the same medicines, made by the same companies, often in the same plants. There is no market justification for this. There is only the fact that American consumers have been the profit center subsidizing everyone else’s price controls, and nobody in Washington was willing to say so out loud with any leverage behind it.
The leverage is the whole story. Trump paired the ask with a credible threat of 100 percent tariffs on imported pharmaceuticals under a Section 232 investigation. That’s what brought Pfizer to the table last September. Eleven months later all 17 originally targeted manufacturers have signed, plus nine more: Alcon, Astellas, BeOne, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva, and UCB. The drugs involved treat Parkinson’s, hemophilia, glaucoma, macular degeneration, liver disease, and multiple cancers. The companies also agreed that future medicines will launch under the same framework.
There’s a second piece that deserves more attention than it’s getting. The nine new signatories committed at least $19.6 billion in near-term U.S. manufacturing investment, and several are stocking the Strategic Active Pharmaceutical Ingredients Reserve — UCB with 163 tons of an anti-seizure drug, Sun Pharma with 78 tons of antibiotics, Astellas with the immunosuppressant transplant patients depend on. COVID taught everyone that our medicine cabinet runs through supply chains we don’t control. This is one of the few concrete responses anyone has produced.
The objections are real and worth stating. Democrats argue the deals don’t go far enough and that individual terms aren’t public. A Health Affairs analysis in July agreed savings will vary considerably by drug and coverage type. But that same center-left journal concluded the agreements amount to a genuine shift in federal drug-pricing policy rather than theater — which is not a sentence the RNC wrote.
Fair enough on the transparency point. Publish the terms. Let the CBO score it. Serious policy should survive scrutiny.
But note what the criticism concedes: the argument is no longer about whether Trump did anything. It’s about how much. That’s a considerably better place to be than where the last five administrations left this file, which was in a drawer, under a press release.
Shame on Democrats for pooh-poohing Trump’s efforts; their party has literally done nothing but talk about lowering drug prices – some day, some way, down the road.
