❓WHAT HAPPENED: Some pharmaceutical companies not directly contacted by the Trump administration to lower U.S. drug prices are seeking to craft their own agreements to avoid potential tariffs and price-setting programs.

👤WHO WAS INVOLVED: The Trump administration, pharmaceutical companies including Bayer, Pfizer, Eli Lilly, and industry groups such as PhRMA and the Midsized Biotech Alliance of America.

📍WHEN & WHERE: Ongoing discussions following directives issued by the Trump administration in the U.S.; recent comments made at the JP Morgan Healthcare Conference in San Francisco.

💬KEY QUOTE: “The Trump administration, of course, wants to negotiate deals that meaningfully lower drug prices for American patients with every pharmaceutical company,” said White House spokesman Kush Desai.

🎯IMPACT: Companies without deals face potential Medicare price-setting pilot programs, which could significantly impact pricing and revenue structures, particularly for mid-sized firms.

Several pharmaceutical companies left out of the Trump administration’s initial drug pricing agreements are now seeking to negotiate their own deals, aiming to avoid potential tariffs and new Medicare price-setting initiatives, according to industry sources. Companies have begun contacting the White House and the Centers for Medicare & Medicaid Services to explore possible arrangements.

“The Trump administration, of course, wants to negotiate deals that meaningfully lower drug prices for American patients with every pharmaceutical company,” White House spokesman Kush Desai said.

The administration has already reached agreements with 16 major drugmakers, including Pfizer and Eli Lilly, to reduce prices on medicines sold through Medicaid. In exchange, those companies are shielded from future government price-setting measures. The deals are part of President Donald J. Trump’s broader push to lower U.S. drug prices by tying them more closely to prices paid in other developed nations. Additional agreements announced in recent months expanded the initiative to more large pharmaceutical firms, marking what the administration described as significant progress in cutting prescription costs for American patients.

However, many mid-sized and smaller drug manufacturers were not included in the initial round of negotiations. Bayer’s Global Head of Pharmaceuticals, Stefan Oelrich, said companies that were not contacted should still have a chance to participate. “Otherwise, that would be very odd, that only because you have size that you would get different treatment,” Oelrich stated.

Some smaller firms have formed a new trade group, the Midsized Biotech Alliance of America, to advocate for more inclusive negotiations and to push back against Medicare pilot programs known as GLOBE and GUARD. These pilots would require drugmakers to provide rebates if U.S. prices exceed those charged in certain foreign markets, potentially forcing broader price reductions under Medicare. While Medicaid represents about 10 percent of U.S. drug spending, Medicare’s larger footprint could create greater financial pressure.

Sanofi CEO Paul Hudson has indicated that larger companies may be better positioned to absorb pricing concessions, while mid-sized firms with fewer products face greater risk. “A lot of them are very worried that… they’re going to get stuck with what the bigger guys did that works for them and doesn’t work for the mid-sized guys,” said an industry lobbyist.

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