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Trump to sign order to cut some U.S. drug prices to match those abroad
US President Donald Trump participates in a celebration of military mothers in the East Room of the White House in Washington, DC, on May 8, 2025.
Jim Watson | AFP | Getty Images
President Donald Trump on Monday will revive a controversial policy that aims to slash drug costs by tying the amount the government pays for some medicines to lower prices abroad, White House officials said.
Trump will sign an executive order including several different actions to renew that effort, known as the “most favored nation” policy.
“For too long, foreign nations have been able to free ride off of the American people, and American patients forced to pay for too much for prescription drugs,” one official told reporters on Monday.
“The president is dead serious about lowering drug prices,” they said.
Shares of U.S. drugmakers dropped in premarket trading Monday ahead of the official announcement. Eli Lilly fell more than 5%, while Pfizer, Merck and Johnson & Johnson dropped more than 2%.
But White House officials did not disclose which medications the order will apply to. They said Monday’s announcement will be broader than a similar policy that Trump tried to push during his first term, which only applied to Medicare Part B drugs.
It’s unclear how effective the policy will be at lowering costs for patients. In a social media post on Monday, Trump claimed drug prices will be cut by “59%, PLUS!”
The order directs the Office of the U.S. Trade Representative and the Department of Commerce to crack down on “unreasonable and discriminatory policies” in foreign countries that “suppress” drug prices abroad, the officials said. It also directs the Secretary of the Department of Health and Human Services to encourage “most favored nation prices.”
Within 30 days, the secretary will also have to set clear targets for price reductions across all markets in the U.S., according to the officials. That will open up a round of negotiations between HHS and the pharmaceutical industry, officials said, not providing exact details on the nature of those talks.
If “adequate progress” is not made towards those price targets, HHS Secretary Robert F. Kennedy Jr. will impose the most favored nation pricing on drugs through rulemaking.
The order also directs the Food and Drug Administration to consider expanding imports from other developed nations beyond Canada. Trump signed a separate executive order in April directing the Food and Drug Administration to improve the process by which states can apply to import lower-cost drugs from Canada, among other actions intended to lower drug prices.
It also directs the Department of Justice and Federal Trade Commission to aggressively enforce “anti-competitive actions” that keep prices high in the U.S.
The Department of Commerce will also consider export restrictions that “fuel and enable that low pricing abroad.”
It is Trump’s latest effort to try to rein in U.S. prescription drug prices, which are two to three times higher on average than those in other developed nations – and up to 10 times more than in certain countries, according to the Rand Corporation, a public policy think tank.
The order is a blow to the pharmaceutical industry, which is already bracing for Trump’s planned tariffs on prescription drugs. Drugmakers have argued that the “most favored nation” policy would hurt their profits and ultimately, their ability to research and develop new medicines.
But the policy could help patients by lowering prescription medication costs, which is an issue top of mind for many Americans. More than three in four adults in the U.S. say the cost of medications is unaffordable, according to a KFF poll from 2022.
The industry also lobbied against similar Trump plans during his first term. He tried to push the policy through in the final months of that term, but a federal judge halted the effort following a lawsuit from the pharmaceutical industry. The Biden administration then rescinded that policy.
White House officials initially pressed congressional Republicans to include a “most favored nation” provision in the major reconciliation bill they plan to pass in the coming months, but the policy would have specifically targeted Medicaid drug costs, Politico reported earlier this month. Several GOP members opposed that measure.
How Trump’s order could affect patients, companies
The industry’s largest trade group, PhRMA, estimated that Trump’s Medicaid proposal could cost drugmakers as much as $1 trillion over a decade.
Some health policy experts have said a “most favored nation” drug policy may not be effective at lowering medication costs.
For example, USC experts said the policy “can’t undo the basic economics of the global drug marketplace,” where 70% of pharmaceutical profits worldwide come from the U.S.
“Facing a choice between deep cuts in their U.S. pricing or the loss of weakly profitable overseas markets, we can expect many firms to pull out from overseas markets at their earliest opportunity,” experts said in a report in April.
That will leave Americans paying the same amount for medications, drugmakers with lower profits and future generations of patients with less innovation, they said.
“In sum, everyone loses,” the experts said.
Other experts have said another legal fight with the pharmaceutical industry could prevent the policy from taking effect.
But even if the drug industry pushes back on Trump’s executive order, his administration still has another tool to push down drug prices: Medicare drug price negotiations.
It’s a key provision of the Inflation Reduction Act that gives Medicare the power to negotiate certain prescription drug prices with manufacturers for the first time in history.
Trump last month proposed a change to that policy that drugmakers have long sought. Lawmakers on both sides of the aisle could be receptive to the idea, which proposes changing rules that differentiate between small-molecule drugs and biologic medicines.
Trump last week said he plans to announce tariffs on medicines imported into the U.S. within the next two weeks. Those planned levies aim to boost domestic drug manufacturing.
Drugmakers, including Eli Lilly and Pfizer, are pushing back on those potential duties. Some companies have questioned whether the tariffs are necessary, given that several of them have already announced new U.S. manufacturing and research and development investments since Trump took office.
Still, Trump last week doubled down on efforts to reshore drug manufacturing. He signed an executive order that streamlines the path for drugmakers to build new production sites.
Caplan noted that even if the drug industry pushes back on the executive order, the administration still has another tool at its disposal: Medicare drug pricing negotiations.
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What to know about Kilmar Abrego Garcia’s release from immigration custody
BALTIMORE — Kilmar Abrego Garcia, whose mistaken deportation helped galvanize opposition to President Donald Trump’s immigration policies, was released from immigration detention on Thursday, and a judge has temporarily blocked any further efforts to detain him.
Abrego Garcia currently can’t be deported to his home country of El Salvador thanks to a 2019 immigration court order that found he had a “well founded fear” of danger there. However, the Trump administration has said he cannot stay in the U.S. Over the past few months, government officials have said they would deport him to Uganda, Eswatini, Ghana and, most recently, Liberia.
Abrego Garcia is fighting his deportation in federal court in Maryland, where his attorneys claim the administration is manipulating the immigration system to punish him for successfully challenging his earlier deportation.
Here’s what to know about the latest developments in the case:
Abrego Garcia is a Salvadoran citizen with an American wife and child who has lived in Maryland for years. He immigrated to the U.S. illegally as a teenager to join his brother, who had become a U.S. citizen. In 2019, an immigration judge granted him protection from being deported back to his home country.
While he was allowed to live and work in the U.S. under Immigration and Customs Enforcement supervision, he was not given residency status. Earlier this year, he was mistakenly deported to El Salvador, despite the earlier court ruling.
When Abrego Garcia was deported in March, he was held in a notoriously brutal Salvadoran prison despite having no criminal record.
The Trump administration initially fought efforts to bring him back to the U.S. but eventually complied after the U.S. Supreme Court weighed in. He returned to the U.S. in June, only to face an arrest warrant on human smuggling charges in Tennessee. Abrego Garcia was held in a Tennessee jail for more than two months before he was released on Friday, Aug. 22, to await trial in Maryland under home detention.
His freedom lasted a weekend. On the following Monday, he reported to the Baltimore immigration office for a check-in and was immediately taken into immigration custody. Officials announced plans to deport him to a series of African countries, but they were blocked by an order from U.S. District Judge Paula Xinis in Maryland.
On Thursday, after months of legal filings and hearings, Xinis ruled that Abrego Garcia should be released immediately. Her ruling hinged on what was likely a procedural error by the immigration judge who heard his case in 2019.
Normally, in a case like this, an immigration judge will first issue an order of removal. Then the judge will essentially freeze that order by issuing a “withholding of removal” order, according to Memphis immigration attorney Andrew Rankin.
In Abrego Garcia’s case, the judge granted withholding of removal to El Salvador because he found Abrego Garcia’s life could be in danger there. However, the judge never took the first step of issuing the order of removal. The government argued in Xinis’ court that the order of removal could be inferred, but the judge disagreed.
Without a final order of removal, Abrego Garcia can’t be deported, Xinis ruled.
The only way to get an order of removal is to go back to immigration court and ask for one, Rankin said. But reopening the immigration case is a gamble because Abrego Garcia’s attorneys would likely seek protection from deportation in the form of asylum or some other type of relief.
One wrinkle is that immigration courts are officially part of the executive branch, and the judges there are not generally viewed as being as independent as federal judges.
“There might be independence in some areas, but if the administration wants a certain result, by all accounts it seems they’re going to exert the pressure on the individuals to get that result,” Rankin said. “I hope he gets a fair shake, and two lawyers make arguments — somebody wins, somebody loses — instead of giving it to an immigration judge with a 95% denial rate, where everybody in the world knows how it’s gonna go down.”
Alternatively, the government could appeal Xinis’ order to the 4th U.S. Circuit Court of Appeals and try to get her ruling overturned, Rankin said. If the appeals court agreed with the government that the final order of removal was implied, there could be no need to reopen the immigration case.
In compliance with Xinis’ order, Abrego Garcia was released from immigration detention in Pennsylvania on Thursday evening and allowed to return home for the first time in months. However, he was also told to report to an immigration officer in Baltimore early the next morning.
Fearing that he would be detained again, his attorneys asked Xinis for a temporary restraining order. Xinis filed that order early Friday morning. It prohibits immigration officials from taking Abrego Garcia back into custody, at least for the time being. A hearing on the issue could happen as early as next week.
Meanwhile, in Tennessee, Abrego Garcia has pleaded not guilty in the criminal case where he is charged with human smuggling and conspiracy to commit human smuggling.
Prosecutors claim he accepted money to transport, within the United States, people who were in the country illegally. The charges stem from a 2022 traffic stop in Tennessee for speeding. Body camera footage from a Tennessee Highway Patrol officer shows a calm exchange with Abrego Garcia. There were nine passengers in the car, and the officers discussed among themselves their suspicions of smuggling. However, Abrego Garcia was eventually allowed to continue driving with only a warning.
Abrego Garcia has asked U.S. District Court Judge Waverly Crenshaw to dismiss the smuggling charges on the grounds of “selective or vindictive prosecution.”
Crenshaw earlier found “some evidence that the prosecution against him may be vindictive” and said many statements by Trump administration officials “raise cause for concern.” Crenshaw specifically cited a statement by Deputy Attorney General Todd Blanche on a Fox News Channel program that seemed to suggest the Justice Department charged Abrego Garcia because he won his wrongful-deportation case.
The two sides have been sparring over whether senior Justice Department officials, including Blanche, can be required to testify in the case.
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Afghan CIA fighters face stark reality in the U.S. : Consider This from NPR
A makeshift memorial stands outside the Farragut West Metro station on December 01, 2025 in Washington, DC. Two West Virginia National Guard troops were shot blocks from the White House on November 26.
Heather Diehl/Getty Images
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They survived some of the Afghanistan War’s most grueling and treacherous missions.
But once they evacuated to the U.S., many Afghan fighters who served in “Zero Units” found themselves spiraling.
Among their ranks was Rahmanullah Lakanwal, the man charged with killing one National Guard member and seriously injuring a second after opening fire on them in Washington, D.C. on Thanksgiving Eve.
NPR’s Brian Mann spoke to people involved in Zero Units and learned some have struggled with mental health since coming to the U.S. At least four soldiers have died by suicide.
For sponsor-free episodes of Consider This, sign up for Consider This+ via Apple Podcasts or at plus.npr.org. Email us at considerthis@npr.org.
This episode was produced by Erika Ryan and Karen Zamora. It was edited by Alina Hartounian and Courtney Dorning.
Our executive producer is Sami Yenigun.
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Video: Behind the Supreme Court’s Push to Expand Presidential Power
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