And then there were none.
With Regeneron announcing a drug-pricing deal with the White House Thursday, all 17 companies targeted in a round of letters by the Trump administration last year have agreed to play ball with the President’s “most favored nation” strategy.
Regeneron—now joining the ranks of MFN policy backers from Novo Nordisk and Eli Lilly to Gilead, Roche and Novartis, among others—has pledged to lower the prices of its drugs on Medicaid in line with other developed nations.
Regeneron is also committing to align the costs of its future therapies with prices "set in that defined group of other countries," the company said in an April 23 release.
As part of the agreement, Regeneron will offer its cholesterol-lowering drug Praluent at a discounted price via the government's online drug purchasing portal, Trumprx.gov, as well.
Dovetailing with the drug pricing announcement Thursday was news that Regeneron received FDA approval for the first gene therapy for genetic hearing loss, Otarmeni, which the company has said it will make available in the U.S. for free.
"For too long, American patients and taxpayers have shouldered a disproportionate share of the cost of biotechnology innovation—effectively subsidizing lower drug prices for other high-income nations that have not been paying their fair share," Leonard Schleifer, M.D., Ph.D., Regeneron's co-founder and CEO, said in a statement.
He continued, "For more than a decade, we have argued that the most direct path to meaningful relief for American patients depends on getting other high-income countries to finally contribute their fair share to the cost of the breakthroughs they rely on just as much as we do."
Regeneron was among 17 major drugmakers targeted last year in a round of letters from the president bidding the companies to embrace the administration’s MFN pricing strategy, which broadly seeks to align U.S. costs with the lowest prices available in comparable developed nations.
The letters, which also targeted companies like Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Merck and Pfizer, among others, urged the drugmakers to provide MFN prices to “every single Medicaid patient,” while also committing not to offer “better prices for new drugs than prices offered in the United States.”
Pfizer inked the first MFN deal with the White House, with AbbVie and J&J the two most recent companies to jump on board prior to Regeneron.
Alongside Medicaid price-reduction pledges, many drugmakers who’ve signed on with the MFN agenda have also made U.S. R&D and manufacturing investment pledges, with the deals conferring a period of immunity from the administration’s threats of pharmaceutical tariffs as well.
For its part, Regeneron has made domestic investment pledges in recent months through a $3 billion commercial manufacturing pact with CDMO Fujifilm Biotechnologies in North Carolina, plus plans to invest around $2 billion into a production site in Saratoga Springs, New York, which the company acquired last April.
In Thursday's release, the company noted that it has pledged more than $9 billion in U.S. manufacturing and R&D investments "in [the] coming years."
Through the agreement, Regeneron has won immunity from "future pricing mandates and will receive tariff relief for three years," the company explained.
While many of the world’s biggest drugmakers have been able to secure drug pricing and tariff deals with the White House, concerns have mounted that the framework overlooks smaller and midsized biopharmas, potentially putting those companies at a disadvantage.
Additionally, lawmakers and patient advocacy groups have been attempting to gather more information about the fine terms of the deals. Democratic Sen. Ron Wyden of Oregon in March sent letters directly to 11 pharmaceutical manufacturers to request more information on what drugs exactly are included in the deals and what state Medicaid programs are actually expected to pay in the wake of the agreements.
Editor's note: This story has been updated with additional information from a Regeneron press release.