US President Donald Trump has written to the chief executives of 17 major pharmaceutical companies, demanding they reduce the price of prescription drugs in the United States to match the lowest rates paid internationally.
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The move follows an executive order Trump signed in May, aimed at forcing drug manufacturers to align US medicine prices with those paid in other developed countries. According to the White House, the letters reiterate that if companies fail to act, the government may resort to regulatory measures or import cheaper medications from abroad.
Among the recipients were senior figures at Pfizer, Eli Lilly, Merck & Co, Sanofi, Johnson & Johnson, Regeneron, and AstraZeneca.In the letters — copies of which were posted on Trump’s social media platform, Truth Social — the former president criticised industry responses to date, stating:
“Most proposals my Administration has received to ‘resolve’ this critical issue promised more of the same; shifting blame and requesting policy changes that would result in billions of dollars in handouts to industry.”
Following the announcement, shares in several pharmaceutical companies dipped. Pfizer, Eli Lilly, and Gilead Sciences each fell around 2%, while the broader NYSE Arca Pharmaceutical Index dropped by 3% on Thursday.
Trump is calling for pharmaceutical firms to provide “most-favoured-nation” pricing to all American patients enrolled in Medicaid, the government programme for low-income individuals. This would ensure that prices in the US are no higher than the lowest prices offered in other OECD (Organisation for Economic Co-operation and Development) countries.
He also urged companies to return excess profits gained from raising prices abroad — a strategy often used to balance lower domestic revenues — and instead redirect those funds back to US patients and taxpayers through government-negotiated agreements.
Further, the letters demand that companies guarantee they will not offer better prices to any other developed nation than those provided to the United States. Trump also proposed a new model allowing pharmaceutical companies to bypass traditional supply chains and sell directly to patients — provided they do so at the lowest internationally available rates. Pharmaceutical firms have been given until 29 September to respond with binding commitments.
“If you refuse to step up,” Trump warned, “we will deploy every tool in our arsenal to protect Americans from abusive drug pricing practices.”
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Analysts and healthcare experts remain doubtful about the practical impact of Trump’s intervention. Stacie Dusetzina, a professor of health policy at Vanderbilt University, said companies may consider offering a limited range of products at lower prices through direct sales channels, but broader compliance seemed unlikely. UBS analyst Trung Huynh described the letters as a repeat of earlier initiatives, dismissing their significance as “just another shot in the dark.”
Despite the scepticism, some companies indicated a willingness to engage. Pfizer, Novartis, AbbVie and the US division of Germany’s Merck KGaA, EMD Serono, all stated they remained open to dialogue with the Trump administration.
Amy Rose, a spokesperson for Pfizer, commented: “Pfizer is working closely with the Trump Administration and Congress to improve access and affordability for American patients. Our discussions have been productive.”
American patients consistently pay far more for prescription medicines than those in other developed countries — often up to three times as much. While the US invests significantly in pharmaceutical research and development, critics argue that this should not come at the cost of affordability.
Pharmaceutical companies have long warned that aggressive price caps could undermine innovation and hinder the development of new treatments. Trump’s latest move may keep pressure on the sector — but whether it brings about meaningful reform remains to be seen.
