The White House intensified its campaign against high drug costs on Thursday, with Press Secretary Karoline Leavitt announcing that President Trump had sent 17 letters to major pharmaceutical CEOs. In the letters, Trump demanded immediate price reductions and warned he would “deploy every tool” available to enforce lower costs if companies failed to comply. He framed the move as a direct effort to protect American families from what he described as abusive industry practices.
One of the most pointed letters was directed to Eli Lilly CEO David Ricks, where Trump pledged to end what he called “global freeloading.” He referred to an executive order he signed in the spring aimed at curbing pharmaceutical prices. Declaring that “this unacceptable burden on American families ends with my administration,” Trump gave the companies 60 days to act or face sweeping federal intervention.
The demands outlined in the letters included extending “most favored nation” pricing to Medicaid, ensuring new drugs launch at the lowest international rate, redirecting revenues from overseas sales back to American patients, and allowing direct government purchasing of medicines at internationally benchmarked prices. Leavitt added that Trump expected good-faith negotiations with the CEOs in the coming weeks.
In May, Trump issued an executive order promising to cut prescription drug costs by 30% to 80%. The order directed the Department of Health and Human Services to establish price targets within 30 days. However, the White House said discussions between HHS officials and pharmaceutical companies yielded little progress, with Trump accusing drugmakers of offering recycled proposals that favored industry interests rather than patient relief.
The administration also signaled a willingness to impose penalties on noncompliant firms, including expanded drug importation, restrictions on exports, and potential revocation of FDA approvals for unsafe or improperly marketed products. Industry leaders, however, warned that such measures could undermine America’s role in biopharmaceutical innovation, especially as China ramps up its own pharmaceutical capabilities. PhRMA executive Alex Schriver argued that the real solution lies in addressing middlemen in the supply chain and pressuring foreign governments to pay more for U.S.-developed medicines.
Policy experts noted significant legal and regulatory hurdles to Trump’s approach. Analysts cautioned that the administration lacks statutory authority to unilaterally enforce “most favored nation” pricing across the board. While the CMS Innovation Center might test such models within Medicare or Medicaid, experts predicted strong industry resistance and legal challenges. Critics said Trump’s strategy is aimed at leveraging public pressure to force companies into voluntary concessions rather than implementing changes the government cannot currently mandate.
