Former President Donald Trump has announced a new policy targeting leading global pharmaceutical companies. In August, the White House sent letters to 17 top drugmakers, including Pfizer, AstraZeneca, and Novartis, demanding they align US drug prices with those in the lowest-priced developed markets.
For example, if a pill costs $10 in Germany and $50 in the US, companies will be required to lower the American price to $10. The same rule applies to new medications, which must enter the US market at the same price as in other countries.
The administration also requires direct-to-consumer sales via the new Trump RXG website, offering 40–90% discounts and bypassing existing intermediaries. The strictest measure: from October 1, a 100% import tariff on all patented drugs unless companies build manufacturing plants in the US. Only companies that start construction in America will receive tariff exemptions.
Pfizer has already signed the first agreement, accepting the administration’s demands, investing $70 billion, and lowering prices. The remaining companies have one week to decide. In total, over $400 billion in manufacturing investment has already been announced.
The rationale is simple: Americans pay several times more for drugs than the rest of the world, despite making up only 5% of the population but providing 75% of the industry’s profit. Lack of price regulation has kept US drugs among the world’s most expensive.
There are also national security concerns: much of pharmaceutical manufacturing has moved to China, India, and Ireland, creating supply risks. The US now imports over $200 billion in medicines annually, a figure that has tripled in 10 years.
Trump’s strategy aims to force companies to localize production in the US. Early results are visible, with numerous companies announcing major investments. New factories will create thousands of jobs for engineers, chemists, and technicians.
However, risks remain: relocating full manufacturing chains to the US is complex, tariffs may increase drug costs, discount access is often limited to the uninsured, and the first deal covers only part of the portfolio.
The true impact on US consumers will become clear in the coming months. Potential medication shortages may arise, since most drugs are still made abroad. Whether prices will truly fall for Americans—or if new complications emerge—remains to be seen.
