Pharma companies raise prices despite signing “most favored nation” deal with White House

Price hikes arrive despite White House agreements

All 16 drug companies that signed voluntary pricing deals with the Trump administration still raised list prices on hundreds of brand-name drugs in January 2026.

The deals, called “most favored nation” agreements, were meant to lower costs for Medicaid patients and cash-paying customers. A nonprofit drug price research group called 46brooklyn found the increases.

January is historically the month when drug companies roll out their annual price hikes.

872 drugs got more expensive in two weeks

In the first two weeks of January 2026, 872 brand-name drugs saw price increases. The median hike was 4%, the same rate as in 2025.

Affected drugs include treatments for cancer, heart failure, and Type 2 diabetes. COVID vaccine prices also went up.

More increases could still come before the end of January, so the final count for the month may climb higher.

What did companies actually agree to?

Since September 2025, the 16 companies have agreed to offer lower prices to state Medicaid programs and sell some drugs at a discount through a new government website called TrumpRx.gov.

They also pledged to price future drugs in line with other wealthy countries. In exchange, the companies got three-year exemptions from threatened pharmaceutical tariffs.

The full terms of the deals have not been made public.

List prices are just the starting point

List prices are not what most patients actually pay.

Insurers, pharmacy benefit managers, and other middlemen negotiate rebates and discounts off those prices.

Pfizer said that while its list prices went up, the prices insurance companies actually pay went down because of larger rebates. The White House agreed that list prices are not the most important number.

Still, list prices can affect which drugs insurers choose to cover and what some patients pay out of pocket.

Pfizer and Merck both raised prices

Pfizer, the first company to sign an MFN deal back in September 2025, raised prices on 72 products. That included a 15% increase in its COVID vaccine.

Pfizer said the increases were modest and needed to fund research and cover rising costs. Merck raised prices on 18 products, including drugs for HIV and insomnia.

According to 46brooklyn’s drug price analysis for January 2026, all 16 companies that signed deals still moved prices higher.

Most Americans won’t feel the difference

Dr. Ben Rome, a health policy researcher at Brigham and Women’s Hospital, said the deals are likely not very important for most Americans’ drug costs.

The MFN agreements mainly help Medicaid patients and those paying cash without insurance. Most Americans carry commercial health insurance, which the deals do not directly affect.

Medicaid already has a law requiring it to get the lowest price offered to any commercial buyer, so the new Medicaid discounts may add a limited extra benefit.

TrumpRx launched, but its reach is narrow

The White House launched TrumpRx. gov on Feb. 5, 2026, with about 43 drugs available.

The site works as a discount lookup tool for cash-paying and uninsured patients. People with insurance cannot use it, and any discounts do not count toward insurance deductibles.

For most insured Americans, copays through their existing plans are likely cheaper than TrumpRx prices. A month after launch, few drugs had been added and usage data remained unclear.

Medicare negotiations delivered real cuts

A separate program under the Inflation Reduction Act of 2022 lets Medicare negotiate drug prices directly.

Negotiated prices for 10 high-cost drugs took effect Jan. 1, 2026, with discounts ranging from 38% to 79% off previous list prices.

According to a Centers for Medicare and Medicaid Services fact sheet, nearly 9 million Medicare beneficiaries use those 10 drugs for conditions like diabetes, blood clots, and heart failure.

Medicare enrollees are expected to save about $1.5 billion in out-of-pocket costs in 2026.

Some drugs did get cheaper

Eighteen significant price cuts showed up in early January 2026. Four of those cuts came on drugs covered by the Medicare negotiation program.

Boehringer Ingelheim cut the list price of its diabetes drug Jardiance by more than 40%, driven by Medicare negotiation requirements rather than the MFN deal. Outside of Medicare, results were mixed.

Four of the 10 negotiated drugs saw big list price drops, four held steady, and two actually went up.

More negotiations are already underway

Talks on 15 more drugs under the Medicare program are underway, with new prices set to take effect in 2027.

The Trump administration has called on Congress to pass the Great Healthcare Plan, which would lock in MFN savings and extend coverage to TrumpRx purchases.

Drug pricing experts say both the voluntary MFN deals and the legally binding Medicare negotiations will continue to shape what Americans pay.

January 2026 price data shows the system largely in line with prior years despite the new agreements.

What this means for your prescription costs

If you are on Medicare and take one of the 10 negotiated drugs, you may already be paying less as of January 2026. If you are uninsured or pay cash, TrumpRx.

gov may offer lower prices on certain drugs. If you have private insurance, the MFN deals and TrumpRx are unlikely to change what you pay right now.

Patients can compare prices across TrumpRx, GoodRx, Cost Plus Drugs, and their own insurance plan to find the best deal.

This article was created with AI assistance and human editing.

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