US President Donald J. Trump has issued a sweeping ultimatum to 17 of the world’s largest pharmaceutical companies, demanding they drastically lower drug prices for Americans within 60 days or face aggressive regulatory and trade action.
In a formal letter dated July 31, 2025, sent to the CEOs of major drugmakers including Pfizer, Eli Lilly, Merck, Johnson & Johnson, AstraZeneca, Sanofi, Novartis, GSK, AbbVie, Amgen, Gilead Sciences, Bristol Myers Squibb, Boehringer Ingelheim, Novo Nordisk, Regeneron, EMD Serono, and Genentech, Trump lays out a stark choice: comply with new Most-Favored-Nation (MFN) pricing rules or be held accountable for what he calls “freeloading” and “abusive pricing practices.”
“Americans are demanding lower drug prices, and they need them today,” Trump wrote in the letter, stating that U.S. citizens often pay two to three times more than patients in other developed countries for the same medications.
The letter follows an Executive Order Trump signed on May 12, 2025, titled Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients, which aims to end global price disparities and force drug companies to offer U.S. consumers the lowest prices they offer anywhere else.
Trump outlined four key demands in the letter :
• Extend MFN pricing to Medicaid for all existing drugs.
• Guarantee MFN pricing on newly launched drugs for Medicare, Medicaid, and private insurers.
• Repatriate excess overseas profits to benefit American patients and taxpayers.
• Sell directly to U.S. consumers and businesses at MFN pricing, bypassing third-party middlemen.
He emphasized that these terms are non-negotiable and must be met by September 29, 2025, adding that his administration is prepared to “deploy every tool in our arsenal” if the companies fail to comply.
Pharmaceutical industry response has been muted so far, but experts predict fierce debate ahead. Critics argue that such policies could disrupt innovation and international trade, while supporters claim they are long overdue and could provide massive savings to American consumers.
As the 60-day countdown begins, the pharmaceutical giants now face a critical decision: concede to Trump’s terms or prepare for a political and legal battle with potentially global consequences.
