President Donald Trump unveiled agreements with nine additional pharmaceutical companies on Friday to lower prescription drug prices for American consumers, bringing to 14 the number of major drugmakers that have committed to his "most favored nation" pricing initiative.

The deals with Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Gilead Sciences, GlaxoSmithKline, Merck, Novartis and Sanofi were announced during a Roosevelt Room ceremony at the White House. Executives from all nine companies attended the event.

"This represents the greatest victory for patient affordability in the history of American health care, by far," Trump said. "Every single American will benefit."

The agreements follow earlier deals with Pfizer, AstraZeneca, EMD Serono, Eli Lilly and Novo Nordisk. Trump has now secured commitments from 14 of the 17 largest drug manufacturers he targeted in letters sent last July demanding they lower prices.

Johnson & Johnson, AbbVie and Regeneron are the remaining companies among the largest that have not signed deals. Trump said Johnson & Johnson "will be here next week."

Structure of the deals

The pharmaceutical companies agreed to sell their existing treatments to Medicaid patients at the lowest "most favored nation" prices—matching what other developed countries pay for the same medications. A senior administration official said approximately 30 to 40 percent of drugs within Medicaid are priced higher than in overseas markets.

Medicaid beneficiaries will see price relief "nearly immediately," according to administration officials.

The companies also committed to launching new medicines at most-favored-nation prices and to listing their products on a forthcoming direct-to-consumer platform called TrumpRx.gov, which the administration says will launch in January.

In exchange, the drugmakers agreed to a three-year grace period during which their products will not face Trump's planned pharmaceutical-specific tariffs, provided they invest in U.S. manufacturing.

"The majority of each Medicaid portfolio will be priced at MFN effective nearly immediately, protecting our most vulnerable citizens on Medicaid," a senior administration official said during a briefing Friday.

The deals also include a "shared savings mechanism" under which a portion of revenue from higher prices charged to foreign countries will be remitted to the United States.

Trump credited the threat of tariffs with bringing pharmaceutical executives to the table.

"We told them, 'If you don't do it, we're going to have to use tariffs, and we're going to charge you a 10% tariff,' which is far more money than the money we're talking about," Trump said. "And they immediately agreed to do it. They said, 'Is it a threat?' I said, 'Yes, it is a threat,' and they said, 'We will do it,' and they dropped the price."

Most favored nation pricing explained

Trump signed an executive order in May directing the secretary of Health and Human Services to facilitate "direct-to-consumer purchasing programs for pharmaceutical manufacturers that sell their products to American patients at the most-favored-nation price."

Most-favored-nation prices reflect the lowest price that a pharmaceutical company sells its product for globally.

U.S. prescription drug prices on average are nearly three times higher than overseas, according to a 2024 study by the RAND Corporation. Prices for branded drugs were more than four times higher, the report found.

"The days of American families subsidizing cut-rate drugs for the rest of the world are ending," a senior administration official said.

Health and Human Services Secretary Robert F. Kennedy Jr. praised the president during Friday's event.

"This is the best achievement that could happen to our country. This is something Bernie Sanders has been clamoring for for 25 years, Elizabeth Warren has been clamoring for, Joe Biden promised the American people, President Obama, President Clinton, all promised to do this for the American people," Kennedy said. "Nobody has done anything for affordability greater than this."

Emergency drug supplies and manufacturing investments

Several of the companies announced Friday will donate months' worth of medications to the Strategic Active Pharmaceutical Ingredients Reserve.

Merck will donate six months' worth of "a powerful broad spectrum antibiotic," Bristol Myers Squibb will donate six months' worth of apixaban—better known by the brand name Eliquis—and GSK will donate six months' worth of the asthma medication albuterol.

"What makes this particularly unique is these manufacturers are not only donating this [active pharmaceutical ingredient], they're also agreeing to convert these raw ingredients into finished medications when needed during emergencies, and to help distribute them to the Americans that need them most," a senior administration official said.

The new deals also include more than $150 billion in investments across the companies as they expand research, development and manufacturing operations in the United States.

"This is about rebuilding American might," the official said.

Industry shift and remaining questions

Administration officials said pharmaceutical companies that were initially hesitant are now rushing to sign agreements.

"This is no longer a trickle. This is a flood," a senior administration official said. "MFN has gone from a bold policy to an industry standard, and it's happened in record time. Our phones are ringing off the hook. Our inboxes are overflowing with additional pharmaceutical companies that are seeking to sign MFN agreements with the United States government."

"What we've observed is initial industry hesitance collapsing into cooperation," the official added.

Wall Street analysts have said the companies have incentives to strike quick deals rather than risk Trump's ire. Medicaid represents a relatively small portion of their business, and many companies are agreeing to price cuts similar to discount programs they already offer.

"When you saw the lack of impact to earnings of the initial companies' deals, for most coming after, it's a no-brainer," said Chris Meekins, a managing director at Raymond James.

Democrats in Congress this week questioned companies on details of the deals and whether they would actually lower prices for consumers. In a letter sent Thursday to pharmaceutical executives, Sen. Ron Wyden of Oregon and Reps. Richard Neal of Massachusetts, Frank Pallone Jr. of New Jersey and Robert "Bobby" Scott of Virginia wrote that "Congress and the American people remain in the dark about the contours of your agreement with the Trump Administration."

The actual impacts of the agreements reached so far are not fully known, as the details have largely been kept confidential. Critics have noted that most-favored-nation pricing could have a negligible impact on Medicaid patients because the program already guarantees the lowest price offered to any commercial payer.

"For too long, global pricing imbalances have shifted the financial burden of groundbreaking research and development onto the U.S. health care system and ultimately, American patients," Merck CEO Robert Davis said in a statement.