Drugmakers Defy Trump Pressure: Prices Set to Rise on 350+ US Medications in 2026

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Major pharmaceutical companies plan to increase list prices on at least 350 branded medications in the United States starting in 2026, despite ongoing efforts by President Donald Trump’s administration to curb drug costs. Healthcare research firm 3 Axis Advisors shared this data exclusively with Reuters on December 31, 2025, revealing a median hike of about 4%, matching 2025 levels, and affecting critical treatments like cancer drugs and vaccines. This development underscores persistent tensions between industry pricing strategies and federal initiatives aimed at aligning US costs with international benchmarks.

Key Developments in Price Hikes

Pfizer leads with planned increases on roughly 80 drugs, including its blockbuster breast cancer therapy Ibrance, migraine treatment Nurtec, COVID-19 antiviral Paxlovid, and Comirnaty COVID-19 vaccine facing a 15% jump. GSK targets about 20 medicines and vaccines with hikes from 2% to 8.9%, while Sanofi, Novartis, and others contribute to the total exceeding last year’s 250 drugs at this stage. These list prices represent wholesale costs before rebates to pharmacy benefit managers, meaning net prices patients pay may vary based on insurance negotiations.

The increases span vaccines for COVID-19, RSV, shingles, and hospital drugs like morphine and hydromorphone, some seeing over fourfold rises in specific formulations. Unlike generics, where US prices average 67 cents per dollar in other OECD nations, branded drugs drive the disparity, with US prices at 422% of those abroad before rebates. This annual January ritual persists even as actual patient out-of-pocket costs depend on copays, deductibles, and coverage.

Trump’s Aggressive Pricing Push

Since his January 2025 inauguration, President Trump has pressured pharma CEOs through letters, executive orders, and “most-favored-nation” deals matching US prices to the lowest in developed OECD countries. Deals with Pfizer, GSK, Novartis, Boehringer Ingelheim, and AstraZeneca offer tariff relief—such as avoiding 100% duties on imports—in exchange for direct sales at reduced rates via TrumpRx.gov, targeting Medicaid and new drugs. A July 2025 White House fact sheet warned non-compliant firms of “every tool in our arsenal,” with a September deadline unmet by broad industry action.

Yet five deal-making companies still announced hikes, highlighting limits of voluntary pacts amid threats of tariffs and FTC antitrust scrutiny on pay-for-delay tactics. Trump touted these as slashing costs Americans pay “nearly three times more” than peers, but critics note they cover few drugs while list prices climb.

Expert Commentary and Perspectives

Health policy experts express frustration over the hikes’ timing. “These agreements address peripheral issues rather than core drivers like lack of negotiation power,” a policy analyst told Reuters. Vanderbilt’s Stacie Dusetzina doubts direct sales at foreign rates for existing portfolios, predicting pharma will prioritize new drugs.

PhRMA, the industry group, defends hikes as funding R&D for innovations like vaccines, arguing list prices mislead without rebates that cut net costs 30-50% for payers. Patient advocates counter that rebates trap consumers in high deductibles, with AARP noting 2025’s 4.5% median still burdened 28 million skipping meds due to cost. Diverse views emerge: Vizient forecasts 3.35% overall pharmacy inflation in 2026, eased by biosimilars but spiked in pediatrics at 3.93%.

Broader Context and Global Disparities

US patients face the world’s highest drug costs, paying $2.78 per foreign dollar spent across brands and generics in 2022, a gap widening as prices grow faster domestically. Branded biologics amplify this, though unbranded generics—90% of US volume—are cheaper here. Trump’s MFN model seeks parity with nations like France and Japan, where prices are lowest, versus higher ones in Canada or Germany.

Background includes Biden-era Inflation Reduction Act negotiations on 10 high-cost Medicare drugs, now under Trump review, and pharmacy benefit manager scrutiny. Industry claims foreign “free-riding” subsidizes US innovation, with 2025 tariffs looming on imports to reshore manufacturing.

Public Health Implications

For consumers, hikes mean potential copay rises on essentials like shingles vaccines or Ibrance, used by thousands yearly, exacerbating access gaps for uninsured or underinsured. Oncology patients, spending $200 billion annually, face compounded pressure despite targeted deals. Practical steps include checking TrumpRx.gov for MFN pricing on select drugs, appealing insurance denials, or using GoodRx for discounts—up to 80% on some brands.

Healthcare pros must counsel on adherence amid costs; a 2024 KFF poll found 25% rationing meds. Broader impacts: strained Medicare Part D budgets, projected $100 billion spend in 2026, risk premium hikes. Positively, biosimilar competition on Humira-like drugs could offset some inflation.

Limitations and Counterpoints

Data from 3 Axis tracks announced list prices, not final net after rebates, which analysts say absorb much of the 4% median—though opaque and unevenly passed to patients. Not all hikes materialize; some offset prior cuts. Trump’s deals exclude most drugs, and legal challenges to MFN persist from first-term failures.

Pharma argues hikes lag inflation (projected 2.5% CPI in 2026) and R&D costs, up 10% yearly, without addressing generics’ role in 41% foreign volume versus US dominance. Skeptics like Common Dreams decry “jack[ing] up prices” amid Trump’s claims of success, urging congressional price caps.