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Trump to sign order to cut some U.S. drug prices to match those abroad

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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.

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“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!”

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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.

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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.

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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. 

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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.

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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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Video: Will ICE Change Under Its New Leader?

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Video: Will ICE Change Under Its New Leader?
Markwayne Mullin, the new homeland security secretary, has promised a different approach, but how much change is likely? Our reporter Hamed Aleaziz describes what we know.

By Hamed Aleaziz, Sutton Raphael, Thomas Vollkommer, Gilad Thaler, Whitney Shefte and Alexandra Ostasiewicz

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A surprise resignation could open the door for an independent to win a Montana Senate seat

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A surprise resignation could open the door for an independent to win a Montana Senate seat

Seth Bodnar, the former president of the University of Montana, is now running for Senate as an independent

Kirk Siegler/NPR


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BUTTE, Mont. – It’s long been an adage in Montana politics that if you’re running for office, you’d better have a float in the Butte St. Paddy’s Day Parade, which draws thousands to the mining city’s historic uptown, soaking up the nostalgia – and the Guiness. 

Here, you’re just steps from the towering old mining headframes and the one mile long and half mile wide Berkeley Pit. Now shuttered, it was  once one of the world’s largest copper deposits. 

Larry Carden, in a Notre Dame sweatshirt, never misses the parade.

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“You’ll see a lot more boos for the Republicans than you will the Democrats, I can guarantee you that,” he says. 

That’s a nod to Butte’s long history of Democratic politics and a strong labor movement going back to around 1900, when the “Copper King” mine owners ruled Montana business and media, and bribed their way into political office. Today, Carden, who’s retired, is worried that the mega rich are again influencing politics here, and how expensive life is in his home state.

“Between health care and gas and food, and you go to the store the other day, there’s rib steaks $19.99 a pound, you know,” Carden says.  

A political group marches in the St. Patrick's Day parade in Butte, Montana, March 17 2026

A political group marches in the St. Patrick’s Day parade in Butte, Montana, March 17 2026

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This year’s parade followed an unusually turbulent few days in Montana’s political scene – half of its congressional delegation abruptly retired. Despite the state’s recent tilt from purple to deep red, the races for their seats could be more in play now because of the way Senator Steve Daines and Congressman Ryan Zinke, both Republicans, gave up them up and chose their successors. In Daines’ case, he withdrew his candidacy just minutes before the filing deadline. 

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Like a lot of people in Butte, Carden is a longtime Democrat. But he says he’s grown disillusioned with party politics.

“I would rather everything be independent where there is no party designation and then you have to pay more attention to who the person actually is,” Carden says.   

New Candidate opts to go independent

That’s exactly what Seth Bodnar, a former Green Beret running for U.S. Senate, is trying to capitalize on. He joined other candidates mixed in with Irish dancing troupes and fire department floats, as he walked the parade route along Park Street shaking the occasional hand and tossing candy. 

In an interview with NPR earlier in Missoula, Bodnar, who recently resigned his post as University of Montana president, pitched what he says would be his bi-partisan appeal.

“I’m an independent,” Bondar says. “When I raised my right hand at the age of 18 and I swore an oath to this Constitution when I joined the military, not to a political party.”.

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Person over party used to be the playbook in Montana, which some call just one long Main Street. It’s how former Senator Jon Tester used to win despite being a Democrat as the state got redder.

The day after Bodnar formally announced he was gathering signatures to get on the ballot, his long shot bid got taken a lot more seriously. 

Sen. Steve Daines, who was elected to the Senate in 2014, sent shockwaves through the state’s political scene when he announced in a video posted to X that he’d decided not to seek reelection.  

Sen. Steve Daines, R-Mont., speaks at the Senate Finance Committee confirmation hearing for Scott Bessent, President-elect Donald Trump's choice to be Secretary of the Treasury, at the Capitol in Washington, Thursday, Jan. 16, 2025.

Sen. Steve Daines, R-Mont., speaks at the Senate Finance Committee confirmation hearing for Scott Bessent, President-elect Donald Trump’s choice to be Secretary of the Treasury, at the Capitol in Washington, Thursday, Jan. 16, 2025.

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“I’m also very thankful to have served alongside President Trump and my colleagues in the Senate,” Daines said in the video. “Together we built a conservative majority on the Supreme Court, we delivered the largest tax cut in U.S. history, we unleashed American energy dominance and secured our southern border.” 
 
Daines’ late hour withdrawal presumably clears the way for his chosen successor, Kurt Alme, the U.S. Attorney for Montana until he declared his candidacy for Daines’ seat. Daines later said withdrawing earlier could have enticed a prominent Democrat like Tester to enter the race. 

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Independent Seth Bodnar says it reminds him of the Montana of old. 

“We have direct election of senators in the United States in part because of political corruption in this state 125 years ago, Copper Kings trying to buy U.S. Senate seats,” Bodnar says. “That didn’t work back then and it’s not going to work right now.”

But Democrats say Bodnar’s entry as an independent will just split the liberal vote. 

The GOP base is angry too

“Montanans are getting very indignant about what they see as out and out dishonesty,” says Roger Koopman, a former Republican legislator and Montana Public Service commissioner from Bozeman.  

Koopman says the party establishment’s backroom dealing is a gift to Democrats and especially Seth Bodnar, who he says is a liberal running as an independent.

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“They’re going to say, ‘hey, I’m over these Republicans playing games with me, you can’t do that and expect me to vote for you, I’m not going to vote Democrat, but here’s this guy out here who says he’s independent, let me give him a try,’” Koopman says. 

Alme has been keeping a low profile. Political pundits say that might be by design. A campaign spokesperson sent NPR this statement: “Anyone could run for this seat. Kurt is running on his record as the Trump-endorsed candidate of common sense who knows how to be tough on violent crime, dismantle drug cartels, and deliver historic tax relief. Voters will decide, and Kurt is confident in his work serving Montana and helping President Trump put America First.”

At Montana State University, political science department chair Eric Austin says he expects party tensions will cool and Republicans will rally around their nominee by November. 

“I think in part that speaks to the changes in the electorate in the state,” Austin says. “As the state has become more red, people have more strongly affiliated themselves with the Republican Party and less as independents.” 

However, Austin says the midterms will be a referendum on President Trump and there’s growing economic anxiety in Montana. Farmers are getting hurt by Trump’s tariffs. His Iran War has sent fertilizer prices soaring, raised interest rates and the cost of gas. 

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Back in Butte, at the St. Paddy’s Day parade, longtime Democratic activist Evan Barrett says there’s a resurgence in populist resentment in Montana. 

Longtime Montana Democratic party activist Evan Barrett at the St. Patrick's Day parade in Butte, Montana, March 17 2026

Longtime Montana Democratic party activist Evan Barrett at the St. Patrick’s Day parade in Butte, Montana, March 17 2026

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“It’s almost like a repetition of the past,” says Barrett, a one time economic aide to former Governor Brian Schweitzer.  

Ducking into an old storefront to take a break from the spectacle of the parade, Barrett told NPR there’s a feeling in the electorate that a lot of outside money is coming into influence politics, but not staying in Montana and being invested into things like schools. 

“So this is a really wild and different year,” Barrett says. “Anybody that tells you they know what’s gonna happen, well, be a bit skeptical.” 

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President Trump has endorsed last minute Senate candidate Kurt Alme but it’s not clear what kind of effect that might have on voters in November. 

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Video: Savannah Guthrie Says She Believes Her Mother Was Taken for Ransom

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Video: Savannah Guthrie Says She Believes Her Mother Was Taken for Ransom

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Savannah Guthrie Says She Believes Her Mother Was Taken for Ransom

Savannah Guthrie spoke on the “Today” show in her first interview since her mother, Nancy Guthrie, was abducted from her home near Tuscon, Ariz.

“The ransom note, notes for ransom requests came. Did you believe those to be real?” “The two notes that we received that we responded to — I tend to believe those are real.” “Really?” “We still don’t know. Honestly, we don’t know anything. We don’t know anything. So I don’t know that it’s because she’s my mom. But yeah, that’s probably — which is too much to bear to think that I brought this to her bedside, that it’s because of me. And I just say, I’m so sorry, Mommy. I’m so sorry. We need answers. We cannot be at peace without knowing. And someone can do the right thing. And it is never too late to do the right thing.”

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Savannah Guthrie spoke on the “Today” show in her first interview since her mother, Nancy Guthrie, was abducted from her home near Tuscon, Ariz.

By Christina Kelso

March 26, 2026

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