Trump administration sent drugmakers most-favored-nation pricing letters on July 31, 2025
The July 31 letters started the negotiations that led to announced GLP-1 price cuts, but who received them and what they asked for has not been disclosed.
President Trump sent letters to leading pharmaceutical manufacturers on July 31, 2025, outlining steps they must take to bring U.S. prescription drug prices down to match the lowest price offered in other developed nations, according to White House and legal summaries of the policy [1][2]. The letters opened a run of company-by-company negotiations over what the administration calls most-favored-nation, or MFN, pricing [1][2].
The letters followed an executive order signed 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 MFN price targets to manufacturers and to propose a rulemaking plan if significant progress was not made, and to help set up direct-to-consumer purchasing programs for manufacturers selling at MFN prices [1].
The publicly available summaries do not name which manufacturers received the July 31 letters or describe the terms in detail [1][2].
What followed
The first agreement came on September 30, 2025, with Pfizer [1]. According to the White House, it gives every state Medicaid program access to MFN prices on Pfizer products, guarantees MFN prices on all new Pfizer medicines, requires the company to repatriate increased foreign revenue tied to the administration's trade policies, and requires deep discounts on medicines sold directly to patients [1]. The same day, the administration announced TrumpRx, a direct-to-consumer website for buying prescriptions at discounted cash prices rather than through insurance, planned for launch in "early 2026" [1]. At least four Pfizer medicines — Eucrisa, Duavee, Zavzpret and Xeljanz — were named for the site [1].
On November 6, 2025, the White House announced agreements with Eli Lilly and Novo Nordisk [2]. The announced figures:
- Ozempic falls from $1,000 a month to $350, and Wegovy from $1,350 to $350, when purchased through TrumpRx [2].
- Zepbound, and orforglipron if approved, fall from $1,086 a month to an average of $346 through TrumpRx [2].
- If the FDA later approves the Wegovy pill or certain similar oral GLP-1 drugs in each company's pipeline, the initial dose would be priced at $150 a month through TrumpRx [2].
- Medicare prices for Ozempic, Wegovy, Mounjaro and Zepbound would be $245, with state Medicaid programs also getting access at that price [2].
- Medicare beneficiaries would pay a $50 monthly co-pay, and the White House says these prices will let Medicare cover Wegovy and Zepbound for patients with obesity and related conditions for the first time [2].
The agreements also cover other medicines: Emgality at $299 per pen, a $443 discount off list price; Trulicity at $389 a month, $598 off list price; and Novo Nordisk insulins including NovoLog and Tresiba at $35 per month of supply [2]. Novo Nordisk committed an additional $10 billion to U.S. manufacturing, and Lilly has announced at least $27 billion in new U.S. manufacturing investment, according to the White House [2].
Why it matters for patients
The letters themselves did not change the price of any specific drug. The concrete numbers that exist come from the later agreements, and most of the headline prices apply to cash purchases through TrumpRx, not to what a patient pays at a pharmacy counter using insurance [1][2]. One open question flagged when the Pfizer deal was announced is whether a program built around cash prices will have a tangible effect on prices paid by people with insurance [1].
The announced Medicare figures, including the $50 monthly co-pay for beneficiaries, are stated by the White House and cover Ozempic, Wegovy, Mounjaro and Zepbound [2]. How those prices would reach patients in commercial insurance plans has not been disclosed [1][2]. None of the announced prices take effect for a patient until the relevant program launches.
What happens next
TrumpRx was planned for launch in "early 2026," with few specifics released at the time of the Pfizer announcement [1]. The White House fact sheet page lists later MFN announcements dated October 10, 2025; December 19, 2025; February 5, 2026, for the launch of TrumpRx.gov; April 23, 2026, with Regeneron; and August 31, 2026, covering nine additional manufacturers [2]. Under the Lilly and Novo Nordisk agreements, prices for oral GLP-1 drugs are contingent on future FDA approval, which has not been reported [2].
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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