The Trump administration says 26 pharmaceutical manufacturers have now agreed to sell drugs to state Medicaid programs at the same reduced prices those companies already charge buyers in other wealthy countries. The latest round, announced August 31, 2026, added nine more drugmakers to the list and pushed the share of the U.S. branded prescription drug market covered by these agreements to 89 percent. For a household with a family member on Medicaid, or anyone tracking whether Washington’s drug-pricing push is actually growing, the number is worth pinning down precisely: what changed, by how much, and what these companies actually committed to do.
The List Grows to Twenty-Six Manufacturers
On August 31, the White House announced that nine additional manufacturers — Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals and UCB — had signed what the administration calls most-favored-nation, or MFN, pricing agreements. According to the White House’s own fact sheet, that brought the full roster to 26 companies, a list that by the administration’s count now also includes Pfizer, AstraZeneca, EMD Serono, Eli Lilly, Novo Nordisk, Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Genentech, Gilead Sciences, GSK, Merck, Novartis, Sanofi, Johnson & Johnson, AbbVie and Regeneron. The 89 percent figure is the administration’s own estimate of how much of the branded drug market, measured by sales, is now supplied by at least one manufacturer holding an MFN deal.
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What a Manufacturer Actually Signs Up For
Each MFN agreement commits a manufacturer to charge state Medicaid programs no more than the lowest price it charges a comparable developed country for the same drug. The mechanism traces back to a May 12, 2025, executive order directing federal agencies to pursue international reference pricing, followed by letters the administration sent that July to 17 major manufacturers outlining the terms. The first deal, with Pfizer, was announced September 30, 2025, and the roster has grown in rounds since: nine companies signed on in a round the White House announced December 19, 2025, and nine more joined in the round announced this past August 31. Separately, on December 1, 2025, U.S. trade and health officials announced an agreement with the United Kingdom that raises the net price the U.K. pays for new prescription drugs by 25 percent — part of the same broader push to close the gap between what Americans and other countries pay.
Which Diseases and Drugs the New Round Covers
The nine manufacturers added in the August round make drugs used to treat hemophilia, Parkinson’s disease, macular degeneration, glaucoma, liver disease, certain skin conditions and several forms of cancer, according to the White House. Earlier rounds reached medicines for type 2 diabetes, HIV, multiple sclerosis, asthma, chronic obstructive pulmonary disease and hepatitis B and C. The December 2025 round is also the clearest public record of how an MFN commitment can turn into an actual price: the fact sheet from that announcement lists the cholesterol drug Repatha falling from $573 to $239 and the hepatitis C drug Epclusa falling from $24,920 to $2,425 for patients buying directly through the federal TrumpRx portal. Those are cash-pay prices, not Medicaid claims, but they are the most concrete evidence the administration has published of what an MFN commitment does to a specific price tag once it takes effect.
The Manufacturing and Stockpile Commitments Riding Along
The nine companies added in August also committed at least $19.6 billion combined to U.S. manufacturing investment, and several agreed to donate raw drug ingredients to a federal stockpile called the Strategic Active Pharmaceutical Ingredients Reserve. UCB is contributing 163 tons of the anti-seizure drug levetiracetam; Sun Pharma is contributing two antibiotics; Teva is contributing an antibiotic and a blood-pressure medication; and Astellas is contributing an immunosuppressant used to prevent organ-transplant rejection. None of that is a pricing provision — it is a separate set of conditions the administration attached to the same announcement, aimed at reducing U.S. reliance on foreign drug manufacturing during a shortage or emergency.
What the Administration Is Projecting Next
The White House’s Council of Economic Advisers estimates the full run of MFN deals could produce $600 billion in savings over the next decade — an administration projection, not an audited result. The same fact sheet also renews a call for Congress to pass a broader package the administration calls the Great Healthcare Plan, which would go further than these voluntary deals by touching insurance premiums and price transparency rules; that package has not been enacted. A client alert from the law firm Duane Morris, published two days after the August announcement, put the open question plainly for the pharmacies and payers who will have to implement these deals: “important questions remain regarding the operational details of the agreements, including which products will be subject to MFN pricing, how applicable prices will be determined and updated … and how savings will ultimately be reflected in pharmacy acquisition costs and reimbursement.” The count itself — 26 manufacturers, 89 percent of the branded market — is confirmed and dated to this week. How much of it reaches any one Medicaid enrollee’s pharmacy counter is the part still being worked out.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
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