President Donald Trump said Monday that nine more drugmakers have reached agreements with his administration aimed at changing what state Medicaid programs pay for some prescription medicines.
The announcement came during an event in the Oval Office attended by executives from the participating businesses. The administration’s approach, known as most-favored-nation pricing, is meant to connect prices paid in the United States with lower prices available in other countries.
The group joining the program includes Teva Pharmaceuticals, UCB and Sun Pharma. Astellas Pharma and Alcon are participating as well. The remaining four are CSL, BridgeBio, Kyowa Kirin and BeOne Medicines.
For certain medicines covered by the agreements, state Medicaid programs would receive prices tied to those available outside the United States. The companies receive something in return. They will be protected from pharmaceutical tariffs and will not face a similar pricing system through Medicare.
Some of the medicines involved are used by people with Parkinson’s disease and hemophilia. Others treat cancers, liver problems and skin conditions. The agreements also cover drugs for glaucoma and macular degeneration.
The companies made a separate financial commitment connected with the deals. Together, they have pledged at least $19.6 billion for manufacturing in the United States, according to information released by the administration.
Monday’s announcement increases participation in the pricing effort to 26 drug manufacturers. Seventeen had previously joined. Large pharmaceutical businesses such as Eli Lilly, Pfizer and Merck were part of that earlier group.
According to Trump, participating manufacturers make up around nine-tenths of the country’s branded medicine market. He said he expects the rest of the industry to eventually join too.
Getting to this point took some time. Smaller and medium-sized manufacturers had moved more slowly than the large companies in agreeing to the administration’s terms. Some executives had questioned whether joining made financial sense for their businesses. By June, Astellas was the only member of Monday’s group known to have applied for the Medicaid arrangement.
There are still questions about what the agreements will mean in practice. Medicaid does not pay ordinary market prices for many medications now. Existing rules already give the program access to large discounts, while many people enrolled in Medicaid spend relatively little of their own money on prescriptions.
The administration estimates its overall pricing effort could reduce government spending at the federal and state levels by $64.3 billion across 10 years. That figure is a projection, and the eventual savings are not yet known. Much of the information contained in the individual agreements has also remained private.
Democrats in Congress have criticized that lack of disclosure. The administration has sought congressional action that would put the pricing policy into federal law, but lawmakers have said missing details make it difficult for them to determine whether the projected taxpayer savings will actually happen.
Another large group of Americans falls outside the direct reach of these Medicaid agreements. More than 160 million people receive health coverage from an employer, and the deals do not address their prescription costs.
The administration has also created TrumpRx, where participating manufacturers can make some medicines available directly to consumers at discounted prices. The latest companies are expected to participate in that effort as part of their agreements.
For now, the program remains largely untested in practice. No medicine has yet entered the U.S. market under one of these most-favored-nation agreements.
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