Trump’s Drug Price Cut Plan Faces Uphill Battle Despite Bold Promises

Former President Donald Trump has revived one of his most controversial healthcare proposals: a plan to slash U.S. drug prices by tying them to lower costs paid in other wealthy nations. But while the executive order carries bold ambitions, experts say its path to implementation will be steep, slow, and uncertain.

Signed on Monday, the executive order revives the “most favored nation” policy, directing U.S. agencies to benchmark American drug prices against those in countries like France, Germany, and Switzerland — where costs are often a fraction of those in the U.S.

“This is about ending the global freeloading at America’s expense,” Trump said during a White House briefing alongside NIH Director Jay Bhattacharya, claiming some prices could fall by up to 90%.

Broad Scope, Vague Details

Unlike earlier versions of the policy, Trump’s new order expands its scope to cover both Medicare/Medicaid and the commercial market. But the plan lacks details, including:

• Which drugs will be targeted

• Which countries will be used for price comparisons

• How enforcement will be handled

• When — or if — Americans will actually see savings

Policy analysts caution that while the intent is clear, execution is murky.

“Every president wants to lower drug prices,” said Gerard Anderson, a health policy expert at Johns Hopkins. “But the mechanisms here are untested — and in some cases, unworkable.”

Legal and Legislative Hurdles Ahead

Trump's first attempt at this policy in 2020 was struck down in court after pharmaceutical companies filed lawsuits. Experts believe the revised version could face similar challenges — and may require congressional approval, which remains unlikely. Several Republicans have already voiced opposition to most favored nation pricing in upcoming economic legislation.

JPMorgan analysts called the new policy “difficult to implement in practice,” citing potential legal battles, industry resistance, and political roadblocks.

Industry Reaction: Watchful, But Not Panicked

Despite the rhetoric, Wall Street wasn’t shaken. Shares of major drugmakers — including Gilead, Merck, Pfizer, and Eli Lilly — rose on Monday, suggesting investors aren’t expecting immediate disruption.

Analysts say the executive order may serve more as a political signal than a true regulatory shift.

“This looks more like a headline than a hammer,” said BMO’s Evan Seigerman, who noted that Trump’s language reflected sympathy toward U.S. drugmakers and frustration with foreign governments.

Pharmaceutical Industry Pushes Back

The pharmaceutical industry, represented by lobbying group PhRMA, applauded the administration’s focus on global pricing disparities but rejected the idea of importing foreign price controls.

“Copying prices from socialist health systems will only weaken innovation, threaten U.S. jobs, and make the country more dependent on China for breakthrough medicines,” PhRMA said in a statement.

They also estimated the policy could cost drugmakers $1 trillion over a decade if applied to Medicaid.

Public and Patient Impact: Unclear

While the White House claimed that patients could start seeing lower prices “almost immediately,” health experts pushed back.

“There’s no timeline, no implementation mechanism, and no list of affected drugs,” said Tricia Neuman of KFF, a health policy research nonprofit. “The savings could vary dramatically depending on which countries are used as benchmarks.”

The administration hinted at targeting high-cost drugs with the greatest U.S.-international price disparities — such as GLP-1 medications for diabetes and weight loss — but stopped short of naming specific treatments.

Other Provisions: Direct Purchases and Imports

The order also proposes:

• Direct-to-consumer drug purchasing at global prices

• New rules for importing medicines from developed countries

• Expanded antitrust action against pricing collusion

However, experts noted that most of these ideas lack timelines or enforcement mechanisms — and could take years to navigate through regulatory or legislative processes.

A Workaround Through Medicare Negotiations?

Some analysts believe the policy might be more viable if limited to Medicare, under existing authorities granted by the Inflation Reduction Act (IRA). In this case, the “most favored nation” price could be used as a starting offer in drug price negotiations — potentially lowering costs for a select group of medications over time.

This would not require new legislation and could produce more modest, manageable effects on the pharmaceutical industry.

Bottom Line

Trump’s latest push to reduce drug prices underscores a bipartisan desire to address U.S. healthcare costs. But with little clarity, limited enforcement tools, and likely legal pushback, experts remain skeptical.

“It’s a headline-grabber,” Anderson said. “But without stronger enforcement power, it's unlikely to shift the landscape in the near term.”

Still, groups like AARP welcomed the effort. “We’re encouraged by any serious attempt to tackle America’s sky-high prescription costs,” said Leigh Purvis, policy lead at AARP. “But the devil is in the details — and those are still missing.”