Overview

• Letters to 17 manufacturers, including Pfizer, Novartis and Eli Lilly, demand proposals by September 29 to offer U.S. prices at the lowest international level or face unspecified measures.
• Novo Nordisk moved first by pledging to halve the U.S. retail price of Ozempic for self-paying patients, while Eli Lilly lifted a U.K. price for a weight-loss drug by 170 percent.
• Transatlantic trade measures now impose a 15 percent U.S. tariff on EU drug imports with the rate potentially rising to 250 percent, ending a long-standing duty-free regime.
• German statutory insurers set prices through fixed amounts and rebate contracts that serve as a reference for other countries, raising the risk that European prices could be pushed up or supplies constrained.
• Implementation faces unresolved legal and logistical questions after a similar Most Favored Nation effort was halted by courts in Trump’s first term, even as stakeholders note the influence of insurers and pharmacy benefit managers on U.S. pricing.