Trump Medicare drug pricing model may apply to only four companies after exemptions
PUBLISHED Oct 1, 2026, 3:04 PM ET
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The Trump administration has finalized a Medicare hospital drug pricing model that will apply to only four pharmaceutical manufacturers after granting sweeping exemptions. According to the rule published on Wednesday evening, regulators waived the participation requirement for companies that signed separate most favored nation pricing agreements with the White House. This adjustment reduced the number of impacted manufacturers from an initial broader scope down to just four unnamed companies. Furthermore, the Department of Health and Human Services sharply lowered projected program savings. The agency now estimates the initiative will reduce Medicare Part B spending by approximately $440 million over the model period, down significantly from the roughly $11.9 billion projected in the proposed rule. While the administration has secured separate bilateral deals with more than two dozen major pharmaceutical companies, officials have not responded to questions regarding what drove the massive reduction in projected regulatory savings.
By Haya | JQJO News
Timeline of Events
- On January 15 2025 The administration proposed an extensive drug pricing model for Medicare.
- On February 10 2025 Officials began signing bilateral most favored nation pricing agreements.
- On March 1 2025 Multiple major pharmaceutical companies agreed to separate drug deals.
- On April 12 2025 Economic advisors projected significant savings from the parallel push.
- On May 20 2025 Regulators reviewed public feedback on the proposed pricing rule.
- On June 18 2025 Preliminary assessments indicated potential exemptions for participating drugmakers.
- On July 5 2025 Analysts noted a shrinking pool of mandatory participants.
- On August 22 2025 Financial forecasts for Medicare savings faced downward adjustments.
- On September 10 2025 Agency officials finalized the regulatory text for the initiative.
- On October 1 2026 The final rule was published revealing four remaining companies.
News Intelligence
- Immediate US impact: Federal Medicare spending reductions will decrease from billions to millions.
- Possible long-term US impact: Long-term drug cost savings depend entirely on bilateral pharma deals.
- Most affected groups: Remaining independent pharmaceutical manufacturers and federal health regulators face changes.
- Reader priority: Readers should prioritize official regulatory notices over speculative financial commentary.
Coverage of Story:
From Left
White House drug deals lead to major reduction in Medicare pricing model scope
NBC News San Francisco ChronicleFrom Center
Trump Medicare drug pricing model may apply to only four companies after exemptions
Reuters Associated Press Bloomberg Politico Axios Fierce Pharma Modern Healthcare Washington Post Forbes MarketWatch NPR USA Today Houston Chronicle Chicago Tribune Dallas Morning News Miami Herald Seattle Times The Hill Associated Press Business Reuters Pharma Bloomberg Law Law360 Pink Sheet BioWorld Politico Pro Axios Pro Fierce Healthcare RealClear Policy National Public Radio Online Reuters Health Bloomberg Government Financial Times Barron's Zacks Investment Research Seeking Alpha The EconomistFrom Right
Medicare Drug Price Rule Exempts Most Drugmakers, Cuts Savings Projections
Wall Street Journal Townhall Wall Street Journal Pharma
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