President Donald Trump says a new executive order could lead to major savings on prescription drugs — up to 59% or more — for American patients. The move revives a controversial policy first introduced during his previous term, but it's already drawing pushback from the pharmaceutical industry and raising questions about whether it can actually deliver on its promises.
Here's what older Americans should know about how it could impact their medication costs — and whether it will stick.
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What Is the "Most Favored Nation" Policy?
Trump's executive order, signed on Monday, targets what's known as a "most favored nation" policy. The idea is to lower U.S. drug prices by tying them to the lowest prices paid for the same medications in other developed countries. During a press event, Trump said, "We are going to pay the lowest price there is in the world."
Unlike past efforts, this new order goes beyond Medicare Part B drugs and could apply to medications across the commercial market, Medicare, and Medicaid. White House officials say it will focus on drugs with the biggest price gaps and highest spending, such as diabetes and weight-loss treatments known as GLP-1 drugs.
How Much Could Prices Really Drop?
Trump posted on Truth Social that prescription costs could fall by "59%, PLUS!" and possibly as much as 90%. But the administration has not yet provided a list of which drugs will be affected or how soon patients might see savings.
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The order also directs the Department of Health and Human Services to work with drugmakers to negotiate price reductions within 30 days. If there's not enough progress, HHS Secretary Robert F. Kennedy Jr. could impose the pricing through formal rulemaking.
In addition, Trump wants to allow Americans to buy directly from drug manufacturers at these lower "favored nation" prices, cutting out middlemen that often drive up costs.
Can It Be Implemented — Or Will Big Pharma Block It?
Even though some patient advocates, including AARP, applauded the move, others are skeptical it will go into effect smoothly. CNBC reports that Wall Street analysts at JPMorgan called it "challenging to practically implement," warning that it may require congressional approval and face legal hurdles.
That's not new. A similar policy proposed during Trump's first term was blocked by a federal judge after the pharmaceutical industry sued. The Biden administration later scrapped it.
The Pharmaceutical Research and Manufacturers of America, the industry's largest lobbying group, criticized the proposal. In a statement, PhRMA CEO Stephen J. Ubl argued that high U.S. drug prices are largely due to foreign governments "not paying their fair share" and to domestic "middlemen" — including pharmacy benefit managers and insurers — who take a significant cut of spending on medicines.
Ubl said giving more of that money directly to patients would do more to lower costs than importing prices from "socialist countries," which he warned could reduce investment in new treatments and make the U.S. more dependent on China for innovation.
Some experts at USC Schaeffer Center have found that the U.S. accounts for 70% of the global drug industry's profits — meaning drugmakers may resist deep cuts in their biggest market.
What Happens Next?
Even if this policy faces delays, Trump's administration has several tools left to tackle drug prices. One is through Medicare's new authority to negotiate prices — a measure passed under the Inflation Reduction Act. Trump has also floated adding tariffs on imported drugs and expanding U.S. manufacturing to lower costs.
For now, the executive order signals an attempt to reduce the cost burden on older Americans — who often take multiple prescriptions and face the steepest out-of-pocket costs. Whether those savings will materialize, or once again be stalled by industry pushback, remains to be seen.
Bottom line: Trump's plan could lead to big savings at the pharmacy counter — but history suggests that legal and political obstacles may slow its rollout.
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