Drugmakers see little financial impact from Trump pricing deals

Big drug companies' pricing deals with the Trump administration had little to no noticeable impact on the bottom line, and the agreements barely came up during the most recent round of quarterly earnings calls. It remains unclear how much patients will ultimately benefit.

Although details of the deals involving more than a dozen leading drug companies are confidential, the industry made concessions on some prices in exchange for more regulatory certainty. The Centers for Medicare and Medicaid Services administrator said much of the price adjustments were for Medicaid, where prices are lower anyway, and that the sector did OK.

Some companies said the deals had been baked into their 2026 outlooks. Pfizer said strategic actions in 2025 helped resolve significant uncertainties, including achieving greater clarity on pricing and tariffs, and demonstrating the underlying resilience of its business. Gilead described any drag on earnings as manageable, noting that the deal it cut with President Trump plus changes to the Affordable Care Act will impact its flagship HIV business by about 2% in 2026.

The outliers were Novo Nordisk and Eli Lilly, the manufacturers of anti-obesity drugs, who portrayed the deals they struck as more impactful. Both companies agreed to lower cash-pay prices for their GLP-1s in exchange for Medicare coverage of the drugs for certain populations. Lilly said lower negotiated prices had a negative impact on its financial outlook, but the concessions will be more than offset by the larger population of people able to access the drugs. Novo Nordisk cited the price concessions as part of why it is forecasting a decline in sales this year, though it is also losing market share to Lilly.

The administration has asked Congress to pass a most favored nation law tying U.S. drug prices to the lowest prices paid in certain other developed nations. That would go much further than voluntary cuts to Medicaid drugs and future drug launches.

Separate claims that Trump initiatives are bringing the world’s lowest drug prices have faced narrower limitations. One program covered 61 of the country’s several thousand prescription medications and was designed to help uninsured, cash-paying patients, but not the 85% of Americans who have prescription drug insurance coverage. In examples cited for that program, a medium dose of Wegovy was priced at $349, compared with $163 in Japan and $198 in Germany; Xigduo was $116 cheaper in Germany; and Xeljanz was $1,653 cheaper there.