President Donald Trump announced nine new most-favoured-nation agreements with pharmaceutical manufacturers on 31 August, expanding the programme significantly.
The latest additions bring the total number of participating companies to 26, which the administration says collectively account for 89% of the branded drug market.
The nine newly added mid-sized manufacturers are Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals (TEVA), and UCB.
Each of the nine agreements pairs Medicaid pricing concessions with commitments to near-term US manufacturing investment and donations to a federal active pharmaceutical ingredient stockpile.
An April 2026 executive order determined that imported pharmaceutical products present a national security threat, imposing additional tariffs and linking relief to manufacturers willing to enter MFN pricing and domestic production agreements.
Companies holding both an MFN and an onshoring agreement benefit from a 0% tariff rate, at least until 2029, giving the pricing concessions concrete commercial value beyond goodwill.
The products covered under these agreements span costly and chronic therapeutic areas including hemophilia, Parkinson’s disease, macular degeneration, glaucoma, liver disease, dermatologic conditions, and multiple cancers.
Every state Medicaid programme gains access to MFN pricing on these companies’ products, with the White House projecting the deals will translate into billions of dollars in aggregate savings.
A companion White House fact sheet frames the agreements as closing off the ability of other countries to use price controls to benefit from American drug innovation without paying comparable prices.
The nine companies collectively pledged at least $19.6 billion in near-term US manufacturing investment, with several also contributing material to the Strategic Active Pharmaceutical Ingredients Reserve.
That stockpile is intended to reduce American dependence on foreign sources of active pharmaceutical ingredients, a supply chain vulnerability that the April executive order specifically cited as a national security concern.
The full MFN roster now includes major companies such as Pfizer (PFE), AstraZeneca (AZN), Eli Lilly (LLY), Novo Nordisk (NVO), Amgen (AMGN), Bristol Myers Squibb (BMY), Gilead Sciences (GILD), GSK (GSK), Merck (MRK), Novartis (NVS), Sanofi, Johnson & Johnson (JNJ), AbbVie (ABBV), and Regeneron (REGN), among others.
Even with 26 manufacturers now committed, the administration is separately pushing Congress to pass the Great Healthcare Plan, broader legislation targeting lower drug prices, reduced insurance premiums, greater insurer accountability, and expanded price transparency.
Unlike the manufacturer-by-manufacturer MFN deals, that broader legislative agenda depends entirely on congressional action, leaving its outcome and further market implications in the hands of lawmakers.
For supply chain and commercialization leaders, pharmacy margins may expand or compress depending on benchmark resets, MAC dynamics, dispensing fees, and contract terms, complicating forward planning.