On September 30, 2025, the Trump administration announced that Pfizer will provide its drugs at most favored nation (MFN) pricing, this is the lowest price paid by developed nations, to Medicaid programs. Pfizer will also provide certain medications direct to cash-paying consumers at a discount through a new website, TrumpRx, that is expected to launch early next year. It's important to note, these prices are only to be available for cash-paying consumers and not available in the employer marketplace.
Since actual MFN pricing has not been shared, it's difficult to estimate the impact of the MFN agreement on Medicaid, especially since Medicaid plans today are entitled to base and inflationary rebates. Also, it's not clear if the prices on the TrumpRx website will be discounted from the drugs net price, after rebates and discounts or the wholesale acquisition cost (WAC). The TrumpRx prices that have been reported for certain Pfizer medications appear to be discounted from WAC, and in at least one case (Toviaz), there are generics available that cost less than the reported TrumpRx price. Direct to consumer programs, are not a new concept. Several manufacturers have offered these programs to cash-paying patients for years however in 2025 Eli Lilly, Novo Nordisk, Bristol Myers Squibb, Pfizer, Boehringer Ingelheim, AstraZeneca, Novartis, and Amgen have all announced such programs.
