Administration sends MFN pricing letters to leading drugmakers
On July 31, 2025, the White House sent letters to major drugmakers demanding US prices match the lowest paid in other wealthy countries — the step that led to the GLP-1 pricing deals announced months later.
On July 31, 2025, President Donald Trump sent letters to leading pharmaceutical manufacturers laying out the steps they would have to take to bring US prescription drug prices in line with the lowest price offered in other developed nations [1][2]. The letters opened a round of company-by-company negotiations that would later reshape the announced prices of semaglutide and tirzepatide.
The letters followed an executive order signed on May 12, 2025, titled "Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients" [1][2]. That order directed the Secretary of Health and Human Services to communicate most-favored-nation (MFN) price targets to manufacturers and, if companies did not make significant progress, to propose a rulemaking plan to force the issue [1]. The order also told HHS to help set up direct-to-consumer purchasing programs for manufacturers willing to sell at MFN prices [1].
The sources do not name which companies received the July 31 letters, and they do not spell out what specific price targets each company was given. That detail is not yet public in these documents.
What the letters produced
The first agreement came two months later. On September 30, 2025, the administration announced a deal with Pfizer that, according to the White House, would give every state Medicaid program access to MFN prices on Pfizer products, guarantee MFN prices on all new Pfizer medicines, require Pfizer to repatriate increased foreign revenue, and require deep discounts when selling directly to American patients [1].
The same day, the administration announced TrumpRx, a direct-to-consumer website where people could buy prescription drugs at discounted cash prices instead of going through insurance [1]. At least four Pfizer medicines — Eucrisa, Duavee, Zavzpret and Xeljanz — were named as available, with a planned launch in "early 2026" [1].
The GLP-1 announcements came on November 6, 2025, when the White House unveiled agreements with Eli Lilly and Novo Nordisk [2]. Under those deals, the price of Ozempic would fall from $1,000 per month and Wegovy from $1,350 per month to $350 when bought through TrumpRx [2]. Zepbound and orforglipron, "if approved," would fall from $1,086 per month to an average of $346 through the site [2]. If the FDA later approved the Wegovy pill or similar oral GLP-1 drugs in either company's pipeline, the initial dose would be priced at $150 per month through TrumpRx [2].
The agreements also set Medicare prices of $245 for Ozempic, Wegovy, Mounjaro and Zepbound, with state Medicaid programs getting access at those prices and Medicare beneficiaries paying a $50 monthly co-pay [2]. The White House said these prices would let Medicare cover Wegovy and Zepbound for adults with obesity and related conditions for the first time [2]. Both companies also agreed to guarantee MFN prices on new medicines and to give every state Medicaid program access to MFN prices [2].
By November 6, 2025, the administration said it had announced five deals with major manufacturers since September 30 [2].
Why it matters for patients
The July 31 letters are the reason later GLP-1 price announcements exist, but the announced numbers are cash prices through a government-linked website, not insurance benefits. One analysis noted that few specifics about TrumpRx were released and that a top open question is whether a program aimed at cash prices will have any tangible effect on what insured patients pay [1].
For people without coverage for weight-loss or diabetes drugs, the gap between roughly $1,000–$1,350 list prices and a $350 cash price is large [2]. For Medicare and Medicaid enrollees, the $245 government price and $50 co-pay would depend on those programs actually implementing coverage [2]. The sources do not say when GLP-1s would appear on TrumpRx, how eligibility would work, or whether all doses would be included.
What happens next
Key dates from the sources: the May 12, 2025 executive order [1]; the July 31, 2025 letters [1][2]; the September 30, 2025 Pfizer deal and TrumpRx announcement [1]; the November 6, 2025 Lilly and Novo Nordisk agreements [2]; and a TrumpRx launch planned for "early 2026" [1].
Sources
- https://www.healthcareperspectivesblog.com/2025/10/trump-administration-announces-deal-with-pfizer-on-most-favored-nation-drug-pricing-and-launch-of-trumprx
- https://www.whitehouse.gov/fact-sheets/2025/11/fact-sheet-president-donald-j-trump-announces-major-developments-in-bringing-most-favored-nation-pricing-to-american-patients/
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