President Donald Trump this week unveiled sweeping “Most Favored Nation” drug pricing agreements with nine pharmaceutical companies, promising Americans unprecedented discounts on insulin, cancer treatments, and other life‑saving medicines. For millions of families struggling under the weight of prescription costs, the announcement sounded like long‑awaited relief. But policy experts say much of what is being promoted under Trump’s “TrumpRx” program closely mirrors reforms enacted under President Joe Biden, raising concerns about whether the public is being misled about who delivered the underlying changes.

The White House highlighted dramatic examples of price reductions, including Plavix dropping from $756 to $16, Epclusa falling from $24,920 to $2,425, and insulin capped at $35 per month. For patients who have rationed insulin or skipped doses because of cost, these figures carry enormous emotional weight. Trump presented the deals as proof of his ability to lower drug costs and cast himself as the champion of affordability.

Trump first introduced the idea of “Most Favored Nation” drug pricing in 2020, issuing an executive order that sought to tie Medicare payments for certain medicines to the lowest prices available in other developed nations. The proposal was immediately challenged in federal court by the pharmaceutical industry and blocked before it could take effect. When Biden took office in 2021, his administration formally withdrew the MFN rule, calling it legally flawed and unworkable. Instead of reviving the contested order, Biden pursued a legislative path. In 2022, he signed the Inflation Reduction Act, which gave Medicare the authority to negotiate the prices of high‑cost drugs beginning in 2026 and capped insulin costs at $35 per month for seniors, easing the burden for millions of patients.

Analysts note that many of the provisions now being promoted under Trump’s “TrumpRx” program — particularly the insulin cap and the promise of negotiated drug prices — were established under Biden’s law. Trump’s new announcement, they say, is less a groundbreaking reform than a rebranding of Biden’s achievements. The White House now touts the $35 insulin cap as part of TrumpRx, even though it was already enacted under the Inflation Reduction Act. Trump’s claim of negotiating lower prices with pharmaceutical companies also overlaps with the authority granted to Medicare by Biden’s legislation. While nine drugmakers have signed on to MFN agreements under TrumpRx, several major firms remain outside the program, leaving gaps in coverage for widely used treatments.

Health policy experts caution that the TrumpRx rollout may not deliver the sweeping savings advertised. Medicaid patients already benefit from guaranteed lowest prices, meaning the MFN framework adds little new benefit for them. TrumpRx promises patients access to international benchmark prices. Still, most Americans rely on insurance plans that negotiate discounts, and in many cases, co‑pays or negotiated rates will remain cheaper than TrumpRx’s cash‑pay model. Several major pharmaceutical companies, including AbbVie and Johnson & Johnson, have not joined the MFN agreements, limiting the program’s reach. Analysts also point out that the $35 insulin cap and Medicare’s authority to negotiate prices were established in Biden’s 2022 law, meaning TrumpRx repackages these measures with new branding rather than expanding them universally.

The announcement underscores Trump’s effort to frame himself as the architect of drug pricing reform. This policy area resonates deeply with voters who have felt the pain of choosing between groceries and medicine. Critics argue that the rollout is less a breakthrough than a repackaging of Biden‑era reforms. Supporters counter that Trump is bringing renewed pressure on pharmaceutical companies and expanding the scope of reforms beyond Medicare. The political stakes are significant: drug pricing has long been a bipartisan issue, and both parties have sought to capitalize on public frustration over soaring costs. Analysts note that Trump often seeks to rebrand existing policies under his own banner, turning incremental changes into headline‑grabbing victories.

For patients and families, the promise of lower drug prices is not abstract — it is about survival, dignity, and the ability to live without fear of financial ruin from a prescription. Biden’s Inflation Reduction Act marked a turning point, demonstrating that the government could stand up to Big Pharma and deliver fairness to patients. Trump’s MFN announcement is real, but the dramatic claims of overnight price drops are misleading. The foundation for Medicare drug negotiations and insulin caps was laid during Biden’s presidency, meaning Trump’s “TrumpRx” program is less a revolution than a rebranding of Biden’s work. For millions of Americans, the progress already made offers hope that affordable medicine is possible and that no one should have to choose between their health and their survival.

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References

1. Federal courts block Trump’s MFN rule (2020):
   https://natlawreview.com/article/federal-courts-block-implementation-most-favored-nation-drug-pricing-rule
2. Biden administration rescinds MFN rule (2021–2022):
   https://www.federalregister.gov/documents/2021/12/29/2021-28225/most-favored-nation-mfn-model
3. Inflation Reduction Act (2022) — Medicare negotiation & insulin cap:
   CMS Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/medicare-drug-price-negotiation-program-negotiated-prices-initial-price-applicability-year-2026
   KFF Overview: https://www.kff.org/medicare/faqs-about-the-inflation-reduction-acts-medicare-drug-price-negotiation-program/
4. TrumpRx announcement (2025) — nine pharmaceutical companies:
   USA TODAY: https://www.usatoday.com/story/money/2025/12/19/trump-announces-drug-pricing-deals-companies/87845715007/
   CBS News: https://www.cbsnews.com/news/trump-announces-agreements-with-9-more-drugmakers-to-lower-prices-for-medicaid-recipients/
   White House Fact Sheet: https://www.whitehouse.gov/fact-sheets/2025/12/fact-sheet-president-donald-j-trump-announces-largest-developments-to-date-in-bringing-most-favored-nation-pricing-to-american-patients/