On 15 April 2025, US President Donald J Trump issued an executive order aiming to lower prescription drug prices and improve accessibility for US patients.
To support this, the White House issued a Fact Sheet: President Donald J Trump Announces Actions to Lower Prescription Drug Prices [1]. This highlights the actions that were taken by President Trump during his first term and outlines that the executive order now aims to significantly lower drug prices for American patients, especially those on Medicare and low-income individuals, by:
For Medicare:
- Enhancing the Drug Pricing Negotiation Program to exceed its current 22% savings.
- Aligning drug payments with actual hospital acquisition costs, potentially cutting costs by 35%.
- Standardizing payments across care settings, reducing prices by up to 60%.
For Low-Income Patients:
- Insulin could cost as little as US$0.03 (plus a small fee).
- Injectable epinephrine could cost as little as $15 (plus a small fee).
For individual States:
- Supports drug importation programs to lower state-level costs.
- Improves Medicaid deals, especially for costly drugs like sickle-cell treatments.
The Fact Sheet notes that President Trump aims to build a transparent, competitive, and fair prescription drug market by:
- Cracking down on hidden pricing and business practices that allow large corporations to profit at patients’ expense.
- Expanding access to generics and biosimilars, which can cost up to 80% less than brand-name drugs.
- Targeting middlemen, such as pharmacy benefit managers (PBMs), by:
- Requiring greater fee disclosure between PBMs and brokers.
- Directing reforms to improve competition, transparency, and efficiency in the drug supply chain.
These efforts are designed to lower costs, increase accountability, and ensure fairness in the healthcare system.
This executive order comes at a time of urgent need for patients. The substantial price markups on medicines by the Big 3 PBMs is unsustainable, a recent FTC report reveals that the Big 3 PBMs have marked up specialty generic drugs by hundreds to thousands of percent when dispensed through their affiliated pharmacies [2].
Following the issuance of the order, the Biosimilars Forum released a statement [3], whereby the Executive Director Juliana Reed noted, ‘Safe, effective, and lower-cost biosimilars are the clear answer to America’s skyrocketing prescription drug costs.’
In addition, she noted that the Forum ‘is pleased to see the Trump Administration announce meaningful action on several fronts, including reforms to make biosimilars available quickly and efficiently to all Americans who need them, … [accelerate] approval of biosimilars through the FDA, and require transparency and fairness from middlemen.’
In an interview with Specialty Pharmacy Continuum, Andrew Barnhill, the Head of Global Policy at IQVIA noted ‘[The White House is] starting to think about it as a national security issue. If the US does not have its share of launches in the biosimilars market and you have increased trade restrictions, that could result in security risks to the supply chain.’
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Second wave of drugs selected for Medicare price negotiation
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References
1. Fact Sheet: President Donald J. Trump Announces Actions to Lower Prescription Drug Prices – The White House. Available from: https://www.whitehouse.gov/fact-sheets/2025/04/fact-sheet-president-donald-j-trump-announces-actions-to-lower-prescription-drug-prices/
2. GaBI Online - Generics and Biosimilars Initiative. FTC reveals extent of PBM drug mark-ups and profits [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2025 Jun 5]. Available from: www.gabionline.net/reports/ftc-reveals-extent-of-pbm-drug-mark-ups-and-profits
3. Biosimilars Forum Applauds the Trump Administration for Drug Pricing Executive Order. Available from: https://biosimilarsforum.org/2025/04/16/biosimilars-forum-applauds-the-trump-administration-for-drug-pricing-executive-order/
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