Secret Pharma Deals Undercut Trump’s Drug Pricing Claims

The disclosures arrive as the administration touts its “most-favored nation” (MFN) drug-pricing program, which recently expanded to all 50 states, Washington, D.C., and Puerto Rico. While the program claims to tie U.S. prices to those in other wealthy countries, internal contracts suggest the reality is far more restrictive. For instance, agreements with Eli Lilly explicitly exclude blockbuster GLP-1 drugs like Mounjaro and Zepbound from mandatory discounts. Similar exemptions for Novo Nordisk could slash projected Medicaid savings by $1.7 billion.

Beyond price carveouts, the deals include provisions that allow companies to stop supplying medicines to foreign nations under specific conditions. By withdrawing these drugs from international markets, manufacturers can manipulate the price benchmarks used to calculate U.S. costs. Critics argue this strategy incentivizes drug companies to deny access to patients abroad to protect their bottom line in the United States. Furthermore, the administration continues to withhold key details regarding tariff exemptions and expedited FDA review incentives, leaving the full extent of the benefits provided to companies like Pfizer shrouded in redactions.