Overview

• Trump’s ultimatum calls for pharma giants to apply their lowest “most favored nation” prices abroad to U.S. programs including Medicaid, Medicare and private insurers by a Sept. 29 deadline.
• The White House demands that companies return extra foreign revenues to U.S. taxpayers and permit direct consumer purchases at most favored nation rates.
• Posting the letters on Truth Social heightened political pressure and coincided with share drops of about 4% at Merck and 2.6% at Eli Lilly.
• While Pfizer and Novo Nordisk signaled readiness to collaborate, PhRMA criticized the approach for potentially eroding innovation.
• Legal experts warn that past courts blocked similar international pricing mandates and that major supply chain shifts could take years to materialize.