Trump's Most US Favored Nation (MFN) drug pricing initiatives begin to take effect in early 2026 through voluntary agreements with pharmaceutical companies.
These price decreases are being implemented through the following mechanisms:
TrumpRx.gov portal: A new direct-to-consumer (DTC) platform, expected to launch in early 2026, where participating manufacturers (including Merck, Amgen, AstraZeneca, Eli Lilly, and Novo Nordisk) will offer MFN-aligned discounted prices directly to consumers.
Medicare
and Medicaid discounts: The agreements will also provide MFN-level pricing to
all state Medicaid programs and expand coverage under Medicare for certain
drugs, such as GLP-1 medications for weight loss and diabetes, with some
Medicare beneficiaries expecting copays around $50 per month.
Separately, the first round of drug prices negotiated under the Inflation Reduction Act (IRA) of 2022 (a different policy from the Trump MFN initiative) will take effect for Medicare beneficiaries on January 1, 2026. These negotiated prices apply to ten high-cost drugs, including Eliquis, Xarelto, and Jardiance, and are expected to result in significant out-of-pocket savings for Medicare enrollees.
In 2026, President Trump’s "Most-Favored-Nation" (MFN) drug pricing initiatives will begin through several distinct platforms and regulatory models:
TrumpRx.gov Launch (January 2026): This new direct-to-consumer (DTC) platform is expected to go live in early 2026, with some reports specifically citing January 1, 2026. It allows patients to purchase brand-name drugs directly from manufacturers at discounted "cash" prices, bypassing insurance companies.
GENEROUS Model (January 1, 2026): A voluntary five-year model for Medicaid programs is scheduled to begin on January 1, 2026. Under this model, participating manufacturers agree to provide state Medicaid agencies with prices pegged to international benchmarks from eight peer countries (e.g., U.K., Canada, and Japan).
GLOBE Model (October 1, 2026): The Global Benchmark for Efficient Drug Pricing (GLOBE) model, which targets physician-administered drugs under Medicare Part B, is scheduled to begin on October 1, 2026. This model aligns U.S. payments with prices paid in 19 other OECD nations.
Key
Drug Price Examples (Effective 2026)
Several major pharmaceutical companies, including Pfizer, AstraZeneca, Eli Lilly, and Novo Nordisk, have reached MFN agreements to lower specific drug costs on the TrumpRx platform starting in 2026:
Medication Condition Est TrumpRx Price Current List Price
Ozempic Diabetes/Obesity $350/mo $1,000-$1,350
Januvia Diabetes $100/mo $330
Repatha Cholesterol $239/mo $573
Zepbound Obesity $346/mo $1,059
Trulicity Diabetes $389/mo $900
Future Implementations
GUARD Model: The Guarding U.S. Medicare Against Rising Drug Costs (GUARD) model for Medicare
Part D retail drugs is not scheduled to begin until January 1, 2027.
Medicare Price Negotiations: Separate from MFN but coinciding in 2026, the first round of 10 Medicare-negotiated drug prices (originally initiated by the Inflation Reduction Act) also takes effect on January 1, 2026.
Norb Leahy, Dunwoody GA Tea Party Leader
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