After months of coercion, President Donald Trump has found another pharma giant willing to play ball with his "most favored nation" (MFN) drug pricing program.
AstraZeneca has reached an agreement to lower prices for "eligible patients with prescriptions for chronic diseases" in the U.S. and will participate in the TrumpRx direct-to-patient marketing website, the company announced in an Oct. 10 press release. MSNBC first reported AstraZeneca's deal with the Trump administration Friday afternoon.
Late last month, Pfizer became the first pharmaceutical company to explicitly satisfy Trump's MFN demands. Under the MFN pricing approach, the president is pushing companies to align their U.S. prices with lower prices overseas, and part of the push involves encouraging companies to market their drugs directly to patients.
In late July, the president wrote letters to the leaders of 17 large pharmaceutical companies outlining those priorities. He threatened to "deploy every tool in our arsenal" to force companies to comply and gave the industry leaders until Sept. 29 to come to the table with their commitments.
The president's letters also called on the pharma giants to negotiate "harder" on pricing with foreign countries and to repatriate "increased revenues" generated abroad to the U.S. to help lower domestic prices. In its Friday press release, AstraZeneca said its deal satisfies all requests made by the president.
In the months since Trump sent the letters, companies of all stripes have been willing to embrace parts of the president's push. Some pharma giants, such as Bristol Myers Squibb and AbbVie, have pledged to roll out new drugs in the U.K. with premium, U.S.-level prices.
A larger group of companies has embraced the president's DTC agenda. Companies including Amgen, AZ, BMS, Novartis and Boehringer Ingelheim have set up programs to offer their products to cash-paying patients at large discounts to their drugs' list prices.
At an Oval Office event last month, Pfizer became the first company to formalize a comprehensive agreement with the administration. As part of the deal, the company pledged to offer a "large majority" of its primary care treatments and "some select specialty brands" through TrumpRx at discounts averaging 50%. The company also pledged to make $70 billion in investments in the U.S. over the coming years.
In return, the company touted a "three-year grace period" from potential pharmaceutical tariffs.
Like Pfizer, AstraZeneca secured a three-year tariff exemption as part of the deal. Other terms of the AZ deal remain confidential, though the company did say it will provide discounts of "up to 80% off list prices."
Importantly, the discounts being touted under the MFN scheme so far are for cash-paying patients and are unlikely to benefit most Americans. The pharma industry already discounts its products as part of routine insurance coverage negotiations, with those discounts averaging out to 50% among a clutch of top drugmakers last year.
In AstraZeneca's case, the discounts apply to prices in Medicaid, according to a note from UBS analysts seen by Proactive Investors. That system represents less than 5% of the company's U.S. sales, the analysts said.
At the Pfizer event late last month, Trump administration officials touted plans to roll out a series of subsequent deals with pharmaceutical giants. Meanwhile, AstraZeneca has already fulfilled one big piece of Trump's agenda with the company's move this week to break ground on a $4.5 billion drug plant in Virginia.
Editor's note: This story was updated Oct. 13 with information from AstraZeneca's press release and an analyst note.