Making America a “Most-Favored Nation” for Drug Prices: Pfizer and AstraZeneca Step Up First

The United States has begun implementing its new “Most-Favored-Nation” prescription drug pricing policy, a move designed to align what Americans pay for medicines with the lowest prices available in comparable developed nations. Following an executive order signed in May 2025 and formal letters to major pharmaceutical companies this summer, two global leaders — Pfizer and AstraZeneca — have voluntarily reached agreements with the U.S. government to provide American patients and Medicaid programs with those most-favored-nation (MFN) prices. These agreements represent the first steps in a broader federal effort to reduce prescription costs for American patients and taxpayers.

The following is the complete statement released by the White House:

REDUCING DRUG PRICES FOR AMERICANS AND TAXPAYERS

President Donald J. Trump sent letters to leading pharmaceutical manufacturers outlining the steps they must take to bring down the prices of prescription drugs in the United States to match the lowest price offered in other developed nations (known as the most-favored-nation, or MFN, price). The steps include:

• Calling on manufacturers to provide MFN prices to every single Medicaid patient.
• Requiring manufacturers to stipulate that they will not offer other developed nations better prices for new drugs than prices offered in the United States.
• Providing manufacturers with an avenue to cut out middlemen and sell medicines directly to patients, provided they do so at a price no higher than the best price available in developed nations.
• Using trade policy to support manufacturers in raising prices internationally provided that increased revenues abroad are reinvested directly into lowering prices for American patients and taxpayers.

The letters inform manufacturers that if they “refuse to step up,” the federal government “will deploy every tool in our arsenal to protect American families from continued abusive drug pricing practices.”

Letters were sent to:  AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, EMD Serono, Genentech, Gilead, GSK, Johnson & Johnson, Merck, Novartis, Novo Nordisk, Pfizer, Regeneron, and Sanofi.

ENDING GLOBAL FREELOADING ON AMERICAN PHARMACEUTICAL INNOVATION:  President Trump is taking decisive action to rebalance a system that allows pharmaceutical manufacturers to offer low prices to other wealthy nations while charging Americans significantly higher prices.

• According to recent data, the prices Americans pay for brand-name drugs are more than three times the price other Organization for Economic Cooperation and Development nations pay, even after accounting for discounts manufacturers provide in the U.S.
• The United States has less than five percent of the world’s population, yet roughly 75% of global pharmaceutical profits come from American taxpayers.
• Drug manufacturers benefit from generous research subsidies and enormous healthcare spending by the U.S. Government. Instead of passing that benefit through to American consumers, drug manufacturers then discount their products abroad to gain access to foreign markets and subsidize those discounts through high prices charged in America. Americans are subsidizing drug-manufacturer profits and foreign health systems, both in development and once the drugs are sold.

ONCE AGAIN DELIVERING ON PROMISES TO PUT AMERICAN PATIENTS FIRST: Today’s letters are an important step in President Trump’s work to get Americans the best deal in the world on prescription drugs.

• On May 12, 2025, President Trump signed an Executive Order titled: “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients” directing the Administration to take numerous actions to bring American drug prices in line with those paid by similar nations.
• Following the Order, the Administration engaged pharmaceutical manufacturers in discussions to achieve MFN pricing in the United States. Today’s letters indicate that industry proposals have fallen short, and from this point forward, President Trump will only accept from drug manufacturers a commitment that provides American families immediate relief from vastly inflated drug prices and an end to the freeriding by European and other developed nations on American innovations.
• President Trump has been relentless in his effort to address the unfair and outrageous prices Americans pay for prescription drugs:
  • President Trump: “In case after case, our citizens pay massively higher prices than other nations pay for the same exact pill, from the same factory, effectively subsidizing socialism aboard [abroad] with skyrocketing prices at home. So we would spend tremendous amounts of money in order to provide inexpensive drugs to another country. And when I say the price is different, you can see some examples where the price is beyond anything — four times, five times different.”

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ADVANCING MOST-FAVORED-NATION PRICING: The first agreement with a major pharmaceutical company, Pfizer, to bring American drug prices in line with the lowest paid by other developed nations (known as the most-favored-nation, or MFN, price).

• The agreement will provide every State Medicaid program in the country access to MFN drug prices on Pfizer products, resulting in many millions of dollars in savings and continuing President Trump’s historic efforts to strengthen the program for the most vulnerable.
• The agreement ensures foreign nations can no longer use price controls to freeride on American innovation by guaranteeing MFN prices on all new innovative medicines Pfizer brings to market.
• The agreement requires Pfizer to repatriate increased foreign revenue on existing products that Pfizer realizes as a result of the President’s strong America First U.S. trade policies for the benefit of American patients.
• The agreement requires Pfizer to offer medicines at a deep discount off the list price when selling directly to American patients.

DELIVERING REDUCED COSTS: These actions will result in tangible cost savings to American patients and the healthcare system as a whole. Taken together, more than 100 million patients are impacted by the diseases Pfizer’s medicines treat, and many of those will benefit from the President’s successful negotiation of lower prices for Americans. Examples include:

• Eucrisa, a topical ointment for atopic dermatitis, will be made available at an 80% discount to patients purchasing directly.
• Xeljanz, a widely used oral medication for rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis, will be available at a 40% discount to patients purchasing directly.
•  Zavzpret, a commonly utilized treatment for migraines, will be sold directly to patients at a 50% discount.

ENDING GLOBAL FREELOADING ON AMERICAN PHARMACEUTICAL INNOVATION:  Decisive action to rebalance a system that allows pharmaceutical manufacturers to offer low prices to other wealthy nations while charging Americans significantly higher prices is now underway.

• According to recent data, the prices Americans pay for brand-name drugs are more than three times the price other Organization for Economic Cooperation and Development nations pay, even after accounting for discounts manufacturers provide in the U.S.
• The United States has less than five percent of the world’s population, yet roughly 75% of global pharmaceutical profits come from American taxpayers.
• Drug manufacturers benefit from generous research subsidies and enormous healthcare spending by the U.S. Government. Instead of passing that benefit through to American consumers, drug manufacturers then discount their products abroad to gain access to foreign markets and subsidize those discounts through high prices charged in America. Americans are subsidizing drug-manufacturer profits and foreign health systems, both in development and once the drugs are sold.

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Shortly after the White House release, Pfizer and AstraZeneca each issued formal company statements outlining their commitments under the Most-Favored-Nation policy.

Pfizer’s statement on the “Landmark Agreement” with the US Government to Lower Drug Costs for American Patients:

Pfizer Inc. announces a historic agreement with the Trump Administration that will ensure U.S. patients pay lower prices for their prescription medicines while strengthening America’s role as the global leader in biopharmaceutical innovation.

In response to the four points covered in the President’s July 31^st letter, Pfizer has voluntarily agreed to implement measures designed to ensure Americans receive comparable drug prices to those available in other developed countries and pricing newly launched medicines at parity with other key developed markets. Pfizer will also participate in a direct purchasing platform, TrumpRx.gov, that will allow American patients to purchase medicines from Pfizer at a significant discount. The large majority of the Company’s primary care treatments and some select specialty brands will be offered at savings that will range as high as 85% and on average 50%.

Specific terms of the agreement remain confidential.

“We are proud to join President Trump at the White House to celebrate this landmark agreement that is a win for American patients, a win for American leadership, and a win for Pfizer,” said Albert Bourla, Chairman and Chief Executive Officer of Pfizer. “By working closely with the Administration, we are lowering costs for patients and enabling greater investment in the U.S. biopharmaceutical ecosystem by ending the days when American families alone carried the global burden of paying for innovation. This is about putting all patients first and ensuring America remains the world’s leading engine of medical breakthroughs.”

Dr. Bourla continued, “We now have the certainty and stability we need on two critical fronts, tariffs and pricing, that have suppressed the industry’s valuations to historic lows.

We’ve agreed to a three-year grace period during which time Pfizer products under a Section 232 investigation won’t face tariffs, provided we further invest in manufacturing in the United States. Additionally, we’ve established a balanced global pricing approach that continues to recognize the value of innovation while ensuring prices in the U.S. and other developed countries are both reasonable and sustainable, maintaining the strength of the U.S. market alongside other developed nations.

This agreement allows us to invest even more boldly in the United States – fueling growth, creating jobs, and returning manufacturing home. Our U.S. workforce of 31,000 colleagues, supported by 13 manufacturing and distribution sites and 7 major R&D facilities, underscores Pfizer’s vital role in building a stronger American economy.

We are committed to channeling unprecedented resources with an additional $70 billion dedicated to U.S. research, development and capital projects in the next few years. This builds upon our more than $83 billion investment in American biotech innovation from 2018-2024, showing how we are strengthening our commitment at this pivotal moment by shaping the future of medicine with the pursuit of pioneering breakthroughs and ensuring the U.S. remains the global hub for medical progress and improving lives.”

With this agreement in place, Pfizer can fully focus on delivering the next generation of cures, sharpening its focus in the areas where the company’s science, scale and agility can make the biggest difference for patients in areas like oncology, obesity, vaccines, and inflammation and immunology.

About Pfizer: Breakthroughs That Change Patients’ Lives

At Pfizer, we apply science and our global resources to bring therapies to people that extend and significantly improve their lives. We strive to set the standard for quality, safety and value in the discovery, development and manufacture of health care products, including innovative medicines and vaccines. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as one of the world’s premier innovative biopharmaceutical companies, we collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For 175 years, we have worked to make a difference for all who rely on us. 

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Statement of AstraZeneca:

ADVANCING MOST-FAVORED-NATION PRICING: President Donald J. Trump announced the second agreement with a major pharmaceutical company, AstraZeneca, to bring American drug prices in line with the lowest paid by other developed nations (known as the most-favored-nation, or MFN, price).

• The agreement will provide every State Medicaid program in the country access to MFN drug prices on AstraZeneca products, resulting in hundreds of millions of dollars in savings and continuing President Trump’s historic efforts to strengthen the program for the most vulnerable.
• The agreement ensures foreign nations can no longer use price controls to freeride on American innovation by guaranteeing MFN prices on all new innovative medicines AstraZeneca brings to market.
• The agreement requires AstraZeneca to repatriate increased foreign revenue on existing products that AstraZeneca realizes as a result of the President’s strong America First U.S. trade policies for the benefit of American patients.
• The agreement requires AstraZeneca to offer medicines at a deep discount off the list price when selling directly to American patients.

DELIVERING REDUCED COSTS: Today’s actions will result in tangible cost savings to American patients and the healthcare system as a whole.

• 9 million American patients are treated by AstraZeneca medicines and will benefit from the President’s successful negotiation to lower prices.
• The 25 million Americans who suffer from asthma, and the 16 million Americans who suffer from chronic obstructive pulmonary disease (COPD), one of the top ten leading causes of death in the United States, could benefit from these price reductions.
  • BEVESPI AEROSPHERE, an inhaler used to treat chronic obstructive pulmonary disease (COPD), will be made available to patients purchasing directly at a discount equal to 65% of the deal price.
  • BREZTRI AEROSPHERE, an inhaler used to treat COPD, will be made available to patients purchasing directly at a discount equal to 98% of the deal price.
  • AIRSUPRA, an inhaler used to treat asthma symptoms and attacks, will be made available to patients purchasing directly at a discount equal to 96% of the deal price.

INVESTING IN AMERICA TO SECURE PHARMACEUTICAL SUPPLY CHAINS: AstraZeneca is also announcing that it will invest $50 billion in U.S. manufacturing and research and development by 2030.

• The company is building a new facility in Charlottesville, Virginia, which will produce advanced pharmaceutical ingredients to support their chronic disease and oncology pipelines.
• The Virginia facility will create 3,600 highly skilled jobs.

ENDING GLOBAL FREELOADING ON AMERICAN PHARMACEUTICAL INNOVATION:  President Trump is taking decisive action to rebalance a system that allows pharmaceutical manufacturers to offer low prices to other wealthy nations while charging Americans significantly higher prices.

• According to recent data, the prices Americans pay for brand-name drugs are more than three times the price other Organization for Economic Co-operation and Development nations pay, even after accounting for discounts manufacturers provide in the U.S.
• The United States has less than five percent of the world’s population, yet roughly 75% of global pharmaceutical profits come from American taxpayers.
• Drug manufacturers benefit from generous research subsidies and enormous healthcare spending by the U.S. Government. Instead of passing that benefit through to American consumers, drug manufacturers then discount their products abroad to gain access to foreign markets and subsidize those discounts through high prices charged in America. Americans are subsidizing drug-manufacturer profits and foreign health systems, both in development and once the drugs are sold.

DELIVERING ON PROMISES TO PUT AMERICAN PATIENTS FIRST: President Trump is delivering on promises for American patients that the political establishment did not believe were possible.

• On May 12, 2025, President Trump signed an Executive Order titled: “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients” directing the Administration to take numerous actions to bring American drug prices in line with those paid by similar nations.
• On July 31, 2025, President Trump sent letters to leading pharmaceutical manufacturers outlining the steps they must take to bring down the prices of prescription drugs in the United States to match the lowest price offered in other developed nations.
• On September 30, 2025, President Trump announced an agreement with Pfizer to bring MFN prices to American patients.
• President Trump has been relentless in his effort to address the unfair and outrageous prices Americans pay for prescription drugs:
  • President Trump: “In case after case, our citizens pay massively higher prices than other nations pay for the same exact pill, from the same factory, effectively subsidizing socialism aboard [abroad] with skyrocketing prices at home. So we would spend tremendous amounts of money in order to provide inexpensive drugs to another country. And when I say the price is different, you can see some examples where the price is beyond anything — four times, five times different.”

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AstraZeneca announces historic agreement with US Government to lower the cost of medicines for American patients