Trump drug price plan meets resistance from smaller pharma firms
Trump’s drug-price push has locked in big manufacturers, but smaller firms say the math and their business models make the deal hard to swallow.
President Donald Trump’s push to make U.S. prescription drugs the cheapest in the world has produced 17 most-favored-nation agreements covering 86% of the branded drug market. The next stage is running into resistance from smaller manufacturers.
The administration announced its 17th deal with Regeneron on April 23. Every state Medicaid program will get access to MFN prices on Regeneron products. The White House estimates the existing-drug framework could produce $64.3 billion in federal and state savings over 10 years, while a separate prospective MFN framework for future launches could generate $529 billion across all markets. The $64.3 billion estimate depends on state participation, and roughly half of those savings would come from state governments.
The model at the center of the fight, called GENEROUS, launched in January 2026 and is scheduled to run for five years. The Centers for Medicare & Medicaid Services extended the manufacturer application deadline from April 30 to June 11, then pushed the participation-agreement deadline from June 30 to July 17 to give small to mid-sized firms more room to engage. States have until September 10 to apply, and participating states must finalize agreements by September 30.
Large and midsized drugmakers approach pricing differently. Ionis Pharmaceuticals chief executive Brett Monia said his company does not have the breadth of products needed to strike the same kind of deals as bigger rivals and does not see the upside of cutting one. Monia also said firms like Ionis often depend on licensing deals with overseas partners to sell drugs outside the United States, leaving them structurally different from the large companies that can spread risk across far more products.
Interest has been weak. One lobbyist said there is “no real upside” for companies that would be giving up pricing flexibility.
This article was produced by Prism’s automated news system from verified source data, official records, and press releases, then run through automated quality and moderation checks before publishing. The system is built and supervised by the people who set the standards it runs under. Read our full AI policy.
Did this article answer your question?
