White House counts ten years of savings from drug pricing deals that filings say run three

The White House has published a great deal about its most favoured nation drug pricing agreements and almost nothing about how long they last.

The most recent deal was announced on 23 April 2026, when the administration said Regeneron had become the seventeenth manufacturer to sign. That fact sheet says the 17 agreements now cover 86 per cent of the branded drug market. It says Regeneron will cut the cholesterol medicine Praluent from 537 to 225 US dollars for patients buying directly through TrumpRx, supply its new gene therapy Otarmeni to United States patients at no cost, and invest 27 billion US dollars in American research, development and manufacturing by 2029. It does not say for how long any of that holds.

None of the fact sheets do. The first deal, with Pfizer on 30 September 2025, set most favoured nation prices for state Medicaid programmes and specific discounts of 80 per cent on Eucrisa, 40 per cent on Xeljanz and 50 per cent on Zavzpret, with no stated end date. The 6 November 2025 announcement covering Eli Lilly and Novo Nordisk listed GLP-1 prices of about 350 US dollars a month against list prices of 1,000 to 1,350 US dollars, again with no term.

STAT reported on 27 February 2026, when 16 companies had signed, that Securities and Exchange Commission filings show that for at least some of the companies the deals last three years. STAT also reported that the agreements vary company by company and that many details, including duration, have not been released by either the administration or the manufacturers. The article does not name which companies disclosed a three year term, and the detail sits behind a subscription wall.

That matters because the administration's own arithmetic runs much longer. A White House research paper published on 5 May 2026 projects 529 billion US dollars in domestic savings over ten years from new drugs launched under prospective most favoured nation pricing, plus 64.3 billion US dollars in federal and state savings on existing drugs in Medicaid over the same period. The paper states that the administration had reached voluntary agreements with 17 of the largest manufacturers. Its projections assume a ten year horizon, that manufacturers keep offering compliant prices, and that legislation eventually codifies the voluntary agreements into law. No such legislation has been enacted.

The agreements are voluntary in a specific sense. Executive Order 14297, signed on 12 May 2025, gave the Secretary of Health and Human Services 30 days to communicate most favoured nation price targets to manufacturers, and set out what would follow if companies did not comply: rulemaking to impose the pricing, certification of case by case drug importation, antitrust action by the Attorney General and the Federal Trade Commission, a review of pharmaceutical export restrictions, and a review of drug approvals. The deals were struck against that backdrop.

The consumer facing part of the policy is TrumpRx. The White House release announcing it is dated 6 February 2026; the April Regeneron fact sheet says the platform launched on 5 February 2026. The launch release advertised Ozempic falling from 1,028 US dollars to an average of about 350 US dollars a month, Wegovy in pill form to as low as 149 US dollars, Zepbound from 1,088 to about 346 US dollars, and fertility drugs including Cetrotide falling from 316 to 22.50 US dollars.

The prices on the site have since moved. As displayed on 17 August 2026, trumprx.gov advertises the Wegovy pill at 149 US dollars a month, the Wegovy pen at 199, Ozempic at 199 and Zepbound at 299, each against the same list prices cited at launch. The site describes the mechanism as most favoured nation pricing and carries no expiry date, no guarantee period and no list of participating manufacturers.

What is not known is which of the 17 companies have three year terms and which have something else, what happens to a listed price when a term ends, whether the agreements renew automatically, and whether the prices advertised on a government website are contractually binding on the manufacturer at all. The full agreements have not been published. Until they are, the only documents describing a fixed term are the ones the companies file for their investors.