White House, Pfizer Reach First MFN Pricing Agreement; Who's Next?

The White House announced on Sept. 30, 2025 that Pfizer is the first major pharmaceutical company to voluntarily agree to its July 31, 2025 mandate to lower prescription drug prices in the United States to the lowest price offered among other developed nations, a strategy known as most-favored-nation (MFN) pricing (1,2). US President Donald Trump’s administration and Pfizer both issued press releases announcing the deal.

Sept. 30 marked 61 days since July 31, one day over the timeframe Trump had set forth to follow a step-by-step process his office outlined—following a May 12, 2025 executive order—or else the president said the federal government would “deploy every tool in our arsenal to protect American families from continued abusive drug pricing practices” should companies fail to act (3,4).

What is Pfizer agreeing to?

As detailed by the White House, every state Medicaid program in the US will be given access to MFN prices on Pfizer products—ensuring that foreign countries will no longer be able to do the same (1). Pfizer will be required to repatriate increased foreign revenue on existing products that may be realized as part of the new arrangement, and Pfizer medicines will be offered at deep discounts off the list price when sold directly to US patients.

Pfizer said it will also participate in a direct purchasing platform, TrumpRx.gov (not yet live), and that savings on most of the company’s primary care treatments and select specialty brands will average 50% but could be as high as 85% (2).

More specific terms of the agreement have been kept confidential, but in Pfizer’s press release, chairman and CEO Albert Bourla, DVM, PhD, said that the company will also be granted a three-year grace period during which Pfizer products under a Section 232 investigation will not be subject to tariffs provided that Pfizer further invests in manufacturing in the US (2).

What are some of the broader implications for bio/pharma?

This first domino to fall in the push for MFN pricing has the potential to result in significant shifts across the bio/pharmaceutical landscape, affecting everything from R&D priorities to manufacturing strategies.

For those in drug discovery and development, it may necessitate a re-evaluation of investment strategies. Should the US no longer shoulder a disproportionate share of global pharmaceutical profits, the financial calculus for R&D likely changes. In its announcement, Pfizer stated the agreement allows it to "fully focus on delivering the next generation of cures" in high-value areas such as oncology, obesity, vaccines, and immunology (2). This suggests that companies may increasingly prioritize therapeutic areas with the potential for pioneering breakthroughs to justify investments under the new pricing framework.

In drug manufacturing, the agreement could spur a significant increase in domestic investment. The key component of Pfizer's deal—the tariff grace period—comes as the company has committed an additional $70 billion to US research, development, and capital projects in the coming years, aiming to fuel growth, create jobs, and reshore manufacturing (2).

In theory, the agreement stands to set a precedent for other major companies in the industry, potentially leading to a broader onshoring of manufacturing and supply chain infrastructure. The stability and certainty on pricing and tariffs provided by the agreement are seen by Pfizer's leadership as critical factors that will enable more bold investment in the US bio/pharmaceutical ecosystem (2).

Have any other companies responded to the White House’s demand?

Pfizer was one of 17 pharmaceutical companies to receive letters from the Trump administration on July 31, along with AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly and Company, EMD Serono, Genentech, Gilead Sciences, GSK, Johnson & Johnson, Merck & Co., Novartis, Novo Nordisk, Regeneron, and Sanofi (3).

Among those, Lilly was one company that had publicly stated a finite deadline to comply with the MFN directive, saying it expected to make necessary pricing adjustments by Sept. 1, 2025 (5). But with the entire month of September having now elapsed since that announcement was made on Aug. 14, no agreement has been disclosed by either Lilly or the White House.

And while no apparent headway has been made with Johnson & Johnson regarding MFN pricing, US health officials have had former J&J property Tylenol (spun off under Kenvue Brands in 2021) in their crosshairs during September 2025, as the Trump administration attempts to establish a link between the use of acetaminophen during pregnancy and development of autism spectrum disorder and attention-deficit/hyperactivity disorder in children (6).

How else have we covered this story so far?

Pharmaceutical Technology® Group sister brands The American Journal of Managed Care®, Chief Healthcare Executive®, Drug Topics®, HCPLive®, Managed Healthcare Executive®, Medical Economics®, OncLive®, Pharmaceutical Commerce®, Pharmaceutical Executive®, and Pharmacy Times® held a live webinar on Sept. 10, 2025 that brought together a panel of experts with perspectives from economics, investment, law and the payer sector to help unpack the potential impacts of future pharmaceutical costs in the US (7).

The panel was moderated by Ned Milenkovich, PharmD, JD, chair of the Health Care Practice Much Shelist, P.C., and included Brian Corvino, principal and Global Market Access Practice leader, Deloitte US; Neal Masia, PhD, co-founder and chief executive officer, EntityRisk, Inc.; Ali Pashazadeh, founder, chairman, and chief executive officer, Treehill Partners; and George Van Antwerp, MBA, senior vice-president, Prime Therapeutics.

Click here to register for free and watch the full panel, on demand.

References

1. The White House. Fact Sheet: President Donald J. Trump Announces First Deal to Bring Most-Favored-Nation Pricing to American Patients. WhiteHouse.gov, Sept. 30, 2025.
2. Pfizer. Pfizer Reaches Landmark Agreement with US Government to Lower Drug Costs for American Patients. Press Release. Sept. 30, 2025.
3. Lavery, P. Trump Sends Letters to 17 Leading Pharma Companies Outlining Most-Favored-Nation Drug Pricing Protocol. PharmTech.com, Aug. 1, 2025.
4. Lavery, P. Trump Issues Executive Order Aimed at Reducing Prescription Drug Prices for US Patients. PharmTech.com, May 13, 2025.
5. Lavery, P. Lilly Statement: MFN Pricing Targeted for September 1, Pushback on Pharma Tariffs. BioPharmInternational.com, Aug. 18, 2025.
6. Lavery, P. Acetaminophen and Autism: Industry Impacts of the White House Statement. PharmTech.com, Sept. 23, 2025.
7. Medical Economics Staff. Trump’s ‘Most-Favored Nation’ Drug Price Push: Key Takeaways from Our Expert Panel. MedicalEconomics.com, Sept. 11, 2025.