The pharmaceutical industry isn’t yet in the clear

Axios – Thursday, October 9, 2025
By Caitlin Owens

Drug companies’ increasing willingness to negotiate deals with the Trump administration and voluntarily cut some prices may be making a splash, but the real-world impact will probably be underwhelming.

Why it matters: The pharmaceutical industry’s compromises so far can be best viewed as attempts to avoid tariffs or undesirable regulatory action by the Trump administration. And it’s anyone’s guess as to whether they’ll be successful.

Driving the news: The Trump administration is expected to imminently announce more deals similar to the one it announced with Pfizer last week, but multiple drug companies have already taken nearly identical action on their own.

• The Pfizer deal featured the company’s commitment to President Trump’s “most favored nation” pricing plan on drugs sold to state Medicaid programs and on the cost for newly launched drugs. Pfizer also will participate in the TrumpRx sales portal by offering selected drugs at deep discounts off of list prices.
• Other drug companies have already on their own announced plans to sell drugs directly to patients — the central idea of TrumpRx — and price new drugs the same as in other countries.
• The industry, Pfizer included, has also committed hundreds of billions of dollars to building new manufacturing infrastructure in the U.S.

Between the lines: Drug stocks are up in the wake of the Pfizer announcement, and analysts have been quick to note the many reasons why the changes aren’t expected to eat too badly into profits.

• The Pfizer deal did not directly lower prices in Medicare or private health insurance, where most Americans get their coverage.
• Manufacturers also can charge high U.S. launch prices as long as they don’t charge less in comparable wealthy countries.
• “Heavily discounted” drugs already are part of the U.S. pricing landscape, thanks to the proliferation of drug rebates. Plus, it’s not clear how popular direct online drug purchasing will be in a world where most Americans have health insurance.
• What’s more, key details of the Medicaid most-favored nation agreement are unclear, making it hard to accurately evaluate.

The other side: The White House’s goal isn’t necessarily to eat into drug company profits; it’s to lower drug prices in the U.S. while getting other countries to pay more.

• If it’s successful on both fronts, that could be a wash for the industry.
• The drug industry trade group PhRMA said it’s committed to working with the administration but added more should be done to address factors it sees as driving up drug prices, including pharmacy benefit managers and hospitals that abuse the government’s discount drug program.

The big picture: If anything, the Pfizer deal has been greeted with a sense of relief: If it and future deals satisfy Trump’s thirst to go after pharma, they would be a big win compared with steep new tariffs on the sector or adding a most-favored-nation requirement to forthcoming Medicare drug price negotiations.

Yes, but: That perspective may be shortsighted. Other observers predict the last few weeks have simply been the warmup act — and that the administration is ready to extract more concessions from the companies.

• “The number one question we’ve gotten from clients has been whether the [Pfizer] deal is a clearing event for the pharma industry that diminishes any pricing and/or tariff risk going forward,” a Capital Alpha Partners note writes. “Our answer is generally that the [Pfizer] deal may provide a tariff avoidance roadmap of sorts, but that drug pricing and tariff risk remain.”
• The title of a Leerink Partners note answers the question pretty directly: “Medicare Demo(s) Still Likely.”
• “We think overall, President Trump’s actions on drug pricing are likely not going to result in a material wound for the industry; however … more actions are likely to come,” Raymond James analyst Chris Meekins — also a former health official in Trump’s first administration — wrote in a note.

What they’re saying: Pfizer CEO Albert Bourla has said the deal gives the “certainty and stability we need on two critical fronts, tariffs and pricing.”

• While the company was explicitly given tariff relief for three years as part of the announcement, the White House has been quiet about the future of Medicare pricing regulations should more companies come through with deals.

The bottom line: So far, the drug industry has used limited pricing concessions to get out of a tight spot, but that reprieve may be short-lived.

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