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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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Satellite images show Iran school strike hit more buildings than earlier reported
The bombing of an Iranian elementary school that killed some 165 people, many of them schoolgirls, included more targets near the school than has been initially reported, a review of commercial satellite imagery by NPR has found.
The images suggest that the school was hit on Saturday as part of a precision airstrike on a neighboring Iranian military complex — and that it may have been struck as a result of outdated targeting information.
The new images come from the company Planet and are of the city of Minab, located in southeastern Iran. They show that a health clinic and other buildings near the school were also struck. Three independent experts confirmed NPR’s analysis of the additional strike points.
The strike points “look like pretty clean detonation centroids,” said Corey Scher, a postdoctoral researcher at the Conflict Ecology laboratory at Oregon State University.
“These certainly appear like detonation sites,” agreed Scher’s colleague, Oregon State associate professor Jamon Van Den Hoek.
Jeffrey Lewis, a professor at Middlebury College who specializes in satellite imagery, said the imagery was consistent with a precision airstrike.
The images show “very precise targeting,” Lewis told NPR. “Almost all the buildings [in the compound] are hit.”
A satellite image of an Iranian Revolutionary Guard compound taken on March 4, several days after an airstrike destroyed a school on the edge of the compound. The image reveals that half a dozen other buildings in addition to the school were struck.
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Iranian state media said 165 people died in the bombing, which struck a girls’ school. The school was located within less than 100 yards of the perimeter of an Iranian Revolutionary Guard naval base, according to satellite images and publicly available information. The clinic was also located within the base perimeter, although both facilities had been walled off from the base.
Israel has denied involvement. “We are not aware at the moment of any IDF operation in that area,” Israel Defense Forces spokesperson Nadav Shoshani told NPR on Monday. “I don’t know who’s responsible for the bombing.”

At a press conference Wednesday morning, U.S. Defense Secretary Pete Hegseth said that the U.S. is looking into what happened at the school. “All I know, all I can say, is that we’re investigating that,” Hegseth said. “We, of course, never target civilian targets.”
Given Minab’s location in the southeastern part of Iran, Lewis believes it’s more likely the U.S. would have conducted the strike than Israel. As one gets farther south and east in Iran, “a strike is much more likely to be a U.S. strike than an Israeli strike because of the type of munitions and the geographic location,” he said.
Esmail Baghaei, the spokesman for Iran’s Foreign Ministry, called the strike “deliberate” and said that the U.S. and Israel bombed the school in part to tie up Iranian forces in the region with rescue efforts. “To call the attack on the girls school merely a ‘war crime’ does not capture the sheer evil and depravity of such a crime,” he said.
But Lewis said it’s more likely that the strike was the result of an error. Satellite images show that the school and clinic buildings were both once part of the base. The school was separated from the base by a wall between 2013 and 2016. The clinic was walled off between 2022 and 2024.
Lewis believes it’s possible American military planners had not updated their target sets.
“There are thousands of targets across Iran, and so there will be teams in the United States and Israel that are responsible for tracking those targets and updating them,” he said. “It’s possible that the target didn’t get updated.”
The Pentagon did not immediately respond to NPR’s request for additional information about the strike.
NPR’s Arezou Rezvani and NPR’s RAD team contributed to this report.
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Mojtaba Khamenei, son of former supreme leader, tipped to become Iran’s next head of state
Mojtaba Khamenei, the second son of the assassinated Ali Khamenei, is being heavily tipped to succeed his father as supreme leader of Iran, which would pitch a hardliner into the task of steering the Islamic republic through the most turbulent period in its 48-year history and offer a powerful signal that, for now, it has no intention of changing course.
No official confirmation has been given and the announcement may be delayed until after the funeral of Ali Khamenei, which was on Wednesday postponed.
His son is believed to have been the choice of the Islamic Revolutionary Guard Corps (IRGC), and the Israeli defence minister, Gideon Saar, has warned he will be assassinated.
Ayatollah Seyed Khatani, a member of the Assembly of Experts, the body that chooses the new supreme leader, said the assembly was close to selecting a leader.
Rigid in his anti-western views, Mojtaba Khamenei is not the candidate Donald Trump would have wanted. Marco Rubio, the US secretary of state, said on Tuesday that Iran was run by “religious fanatic lunatics” – and Khamenei’s appointment is hardly likely to dispel that opinion.
The choice of supreme leader is made by the 88-strong Assembly of Experts, who in this case are picking from a field of six possible candidates. His election would be a powerful if unsurprising symbol that the government is not looking to find an accommodation with America.
Trump has said the worst-case scenario would be if Khamenei’s successor was “as bad as the previous person”.
There has been speculation for more than a decade that he would be his father’s successor, which grew when Ebrahim Raisi, the elected president and favourite of Khamenei, was killed in a helicopter crash.
Mojtaba Khamenei was born in 1969 and studied theology after graduating from high school. At the age of 17, he went to serve in the Iran-Iraq war, but it was not until the late 1990s that he came to be recognised as a public figure in his own right.
After the landslide defeat of Khamenei’s preferred candidate, Ali Akbar Nategh Nuri, in the 1997 presidential election, where he won only 25% of the final vote, various conservative Iranian groups realised the need to make changes to their structures and Mojtaba Khamenei was central to that project.
He was also seen as instrumental by reformists in suppressing the protests in 2009 that came after allegations the presidential election had been rigged, with his name chanted in the streets as one of those responsible. Mostafa Tajzadeh, a senior member of Iran’s reformist parties who was imprisoned after the vote, alleged that his and his wife, Fakhr al-Sadat Mohtashamipour’s, legal case was under the direct supervision of Mojtaba Khamenei.
In 2022 he was given the title of ayatollah – essential to his promotion. By then he was a regular figure by his father’s side at political meetings, as well as playing an influential role in the Islamic Republic’s Broadcasting Corporation, the government’s official media outlet often criticised for churning out dull political propaganda that many Iranians reject in favour of overseas satellite channels. He has also played a central role in the administration of his father’s substantial financial empire.
His closest political allies are Ahmad Vahidi, the newly appointed IRGC commander; Hossein Taeb, a former head of the IRGC’s intelligence organisation; and Mohammad Bagher Ghalibaf, the current speaker of the parliament.
His rumoured appointment and its hereditary nature has long been resisted by reformists. The former prime minister Mir Hossein Mousavi, referring to the long history of rumours about Mojtaba Khamenei succeeding his father as leader, wrote in 2022: “News of this conspiracy have been heard for 13 years. If they are not truly pursuing it, why don’t they deny such an intention once and for all?”
The Assembly of Experts, in response, denounced “meaninglessness of doubts” and said the assembly would select only “the most qualified and the most suitable”.
Israel on Tuesday struck the building in the Iranian city of Qom, one of Shia Islam’s main seats of power, where the assembly was scheduled, but the building was empty, according to IRGC-affiliated media.
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Video: Senators Question Kristi Noem on ICE Immigration Tactics
new video loaded: Senators Question Kristi Noem on ICE Immigration Tactics
transcript
transcript
Senators Question Kristi Noem on ICE Immigration Tactics
Homeland Security Secretary Kristi Noem repeatedly refused to apologize for suggesting that Alex Pretti and Renee Good, two U.S. citizens shot and killed by agents, were domestic terrorists.
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What we’ve seen is a disaster under your leadership, Ms. Noem. A disaster. What we’ve seen is innocent people getting detained that turn out are American citizens. I could talk about the culture that’s been created here. After the killings of Renee Good and Alex Pretti, when I spoke to Alex’s parents, they told me that you calling him a domestic terrorist — this was directly from them — the day after he was killed, a nurse in our V.A., Alex — one of the most hurtful things they could ever imagine was said by you about their son. Do you have anything you want to say to Alex Pretti’s parents? Ma’am, I did not call him a domestic terrorist. I said It appeared to be an incident of — I think the parents saw it for what it was. In a hearing — recent hearing before the HSGAC committee, C.B.P. and ICE officials testified under oath that their agencies did not inform you that Pretti was a domestic terrorist — during that hearing, stated during that hearing, I was getting reports from the ground, from agents at the scene, and I would say that it was a chaotic scene. How did you think that calling them domestic terrorists at that scene was somehow going to calm the situation? The fact that you can’t admit to a mistake, which looks like under investigation, it’s going to prove that Ms. Good and Mr. Pretti probably should not have been shot in the face and in the back. Law enforcement needs to learn from that. You don’t protect them by not looking after the facts.
By Christina Kelso and Jackeline Luna
March 3, 2026
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