U.S. President Donald Trump speaks about his administration’s health care policy in the Oval Office of the White House in Washington, DC, on August 31, 2026.
Evelyn HochsteinReuter
President Donald Trump on Monday stepped up his efforts to tie domestic drug prices to cheaper foreign drug prices, announcing he had voluntarily struck new pricing agreements with nine drug companies to sell their drugs at lower prices.
According to the White House, the drug companies that have signed the new agreement are Alcon, Astellas, B-One Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals and UCB. Shares of most of these companies were relatively flat at Monday’s close, although Teva and B-One were down about 1%.
Under the new agreement, the nine companies agreed to provide discounts on outpatient drugs to each state’s Medicaid program and to bring the prices each state pays in line with the prices the companies charge in foreign countries. The agreement affects drugs that treat several chronic and rare diseases, including hemophilia, liver disease, skin disorders and certain forms of cancer.
The two companies have committed to investing a combined at least $19.6 billion in U.S. manufacturing in the short term, according to the White House.
Astellas, Sun Pharma, Teva, and UCB also agreed to donate active pharmaceutical ingredients for key products to the federal government’s Strategic Stockpile of These Ingredients, which is intended to reduce dependence on foreign supplies and help the United States be prepared for emergencies. For example, UCB will donate 163 tons of levetiracetam, an anticonvulsant drug used to control and prevent certain types of seizures.
The new agreement brings the total number of companies the Trump administration has drug pricing agreements with to 26 companies, which the president said account for 90% of the domestic drug market. He said the remaining 10% of the industry “will come in” but “they have no choice.”
Over the past year, the Trump administration has entered into drug pricing agreements with 17 other drug companies. pfizer, Eli Lilly and novo nordiskas part of the “most-favoured nation” policy. In May 2025, President Trump signed an executive order reinstating the policy, calling for higher prices outside the United States and an “end to global freeloading.”
The agreement strengthens the White House’s efforts to focus on health care affordability ahead of the midterm elections.
Most-favored-nation agreements signed with the Trump administration are already impacting the commercial strategies, profits, and manufacturing pipelines of major pharmaceutical companies.
To protect against the threat of future tariffs, drug companies are spending billions of dollars to bring manufacturing capacity back to the United States. Companies are also significantly expanding direct-to-consumer channels for their products, including offering their medicines on the president’s TrumpRx portal. Lower prices in the U.S. are weighing on profits, and manufacturers such as Novo Nordisk say it will take time for prescription volumes to offset the decline in revenue.
A 2024 Rand Corporation study found that U.S. prescription drug prices were, on average, nearly three times higher than overseas prices, and brand-name drug prices were more than four times higher, the report found.
PhRMA, an industry group representing many major drug companies, has previously said most-favoured-nation status is not the best way to lower drug costs for Americans, instead blaming pharmacy benefit managers for the price disparity.
The United States is the single most important market for many pharmaceutical companies, regardless of their home country. Despite being located across the Atlantic, European pharmaceutical companies rely heavily on the US market, with half of the continent’s 10 largest companies generating the majority of their sales in the US.
