President Donald Trump sent a letter to more than a dozen major drugmakers on Thursday asking them to reduce the cost of prescription drugs in the United States within 60 days.
In a letter Trump posted on his social media platform Truth Society, drug users were told to provide Medicaid patients with a “full portfolio” of existing drugs at the same price as they were abroad (also known as the “favorite country” rule).
He also told drugmakers to “guaranteed” Medicare, Medicaid and privately insured patients to get a lower price paid abroad with all newly approved drugs “at launch and forward”.
He also asked pharmaceutical manufacturers to return any additional income earned abroad to U.S. taxpayers and create a “direct-to-consumer” option for certain drugs that will also be offered at lower prices.
“There is no doubt that the collaborative effort to achieve global pricing parity will be the most effective way for companies, governments and American patients,” Trump wrote in his letter. “But if you refuse to step up, we will deploy all tools in our arsenal to protect American families from ongoing drug abuse pricing practices.”
Experts say it is unclear whether Trump has the right to force drugmakers to reduce the cost of prescription drugs without the help of Congress.
More importantly, any attempt to do so could be driven hard by the pharmaceutical industry.
“The president may need a tough letter to inspire the pharmaceutical industry to lower prices,” said Tricia Neuman, executive director of the Medicare policy program at KFF, a nonpartisan health policy research group.
“So far, the voluntary approach has not worked to lower the price of drugs,” she added. “When the law forces or competes, drug prices tend to fall.”
Trump repeatedly complained during both tenures that people in the United States pay much more for prescription drugs than people in other countries.
In fact, it is well known that the price of prescription drugs in the United States is as high as 10 times higher, and 10 times higher than other countries of similar size and wealth.
More than a quarter of adults in the U.S. say the cost of drugs is unaffordable, according to a KFF poll.
In May, Trump signed an executive order directing federal health officials to update the implementation of the “most popular nation” rules, a strategy he failed to succeed in his first term.
The 17 letters were sent to major drugmakers on Thursday, such as Eli Lilly, GSK, Pfizer, Merck, Johnson & Johnson, Amgen, Novo Nordisk and Novartis.
NBC News has contacted all 17 companies.
A spokesperson for Novo Nordisk said the company “remains committed to improving access and affordability for patients and we will continue to work hard to find solutions that help people get the medicines they need.”
A spokesman for Eli Lilly said the company is still reviewing the letter and forwarding NBC News to PHRMA, the top lobbying group in the pharmaceutical industry, for comment.
PHRMA did not immediately respond to a request for comment.
The Trump administration does have another tool that can reduce the cost of prescription drugs: Medicare drug pricing negotiations.
The rule allows President Joe Biden to sign a law through Joe Biden that allows Medicare to negotiate the price of the most expensive drugs.
It is estimated that the first round of negotiations will save $6 billion in 2026, when prices are expected to take effect.
correct (July 31, 2025, 5:14 pm ET): A previous version of this article incorrectly stated which pharmaceutical company is still reviewing Trump's letter. It was Eli Lilly, not Johnson and Johnson.
Steve Kopack contributed.