GSK, Novartis, Merck, Gilead, BMS and Amgen cut US drug prices for tariff relief and massive US investment

Six of the world’s largest drugmakers – GSK, Novartis, Merck, Gilead, Bristol Myers Squibb and Amgen – have struck three‑year agreements with the Trump administration to cut US drug prices, expand direct‑to‑patient access and commit tens of billions of dollars to American R&D and manufacturing.

Taken together, these deals form the core of a new TrumpRx and “Most Favored Nation” framework that trades tariff relief and policy predictability for visible price cuts on high‑impact medicines across respiratory, cardiovascular, infectious disease, neurology and immunology care.

GSK: respiratory discounts and SAPIR reserve

GSK’s agreement focuses on lowering the cost of its broad inhaled respiratory portfolio, which treats more than 40 million Americans living with asthma and COPD. The company will cut prices for selected medicines in Medicaid, commit to launch future drugs at more balanced prices across developed markets, and open a direct purchasing platform that can offer savings of up to 66% for US patients.

As part of the Strategic Active Pharmaceutical Ingredients Reserve (SAPIR), GSK will secure a US reserve of albuterol (salbutamol), a critical bronchodilator used in many inhalers, to strengthen domestic supply resilience. The agreement also covers ViiV Healthcare, provides three years of protection from Section 232 tariffs, and supports GSK’s plan to invest more than $30 billion in US R&D and manufacturing over five years, including around $2 billion in new facilities and AI‑enabled digital technologies.

Novartis: TrumpRx platforms and GENEROUS Medicaid model

Novartis has agreed with the US government to align prices for future medicines with those in other high‑income countries while maintaining a strong US manufacturing and innovation base. The company will build direct‑to‑patient platforms for Mayzent (siponimod), Rydapt (midostaurin) and Tabrecta (capmatinib), with access routed through TrumpRx from 2026 to improve affordability and adherence.

Novartis also plans to apply to the GENEROUS Medicaid model (GENErating cost Reductions fOr U.S. Medicaid), which is designed to deepen access and lower net prices for state and federal payers. Earlier this year the company pledged about $23 billion over five years to expand its US footprint, including a $1.1 billion biomedical research hub in San Diego, a flagship manufacturing site in North Carolina and radioligand therapy facilities in California, Florida and Texas, in return for three years of tariff relief.

Merck: historic agreement and oral PCSK9 launch strategy

Merck’s deal with the Trump administration is described by the company as “historic,” combining price and access commitments with a pledge to invest more than $70 billion in US production and innovation. The agreement is intended to keep Merck’s portfolio of medicines and vaccines affordable for American patients while sustaining the company’s long‑term R&D pipeline.

A focal point is enlicitide, a potential first‑in‑class oral PCSK9 inhibitor that could deliver potent LDL‑cholesterol lowering in a daily pill rather than injections. If approved, enlicitide will be offered via a discounted direct‑to‑patient program to eligible Americans as part of Merck’s broader commitment to expand access to cardiovascular therapies under the new framework.

Gilead: infectious disease drugs at global‑parity prices

Gilead’s three‑year agreement is explicitly framed around ending the situation where US payers shoulder a disproportionate share of global spending on its innovative antivirals. The company will provide discounts on selected HIV, hepatitis C, hepatitis B and COVID‑19 medicines in Medicaid, targeting net prices that are similar to those in comparable developed nations.

Looking ahead, Gilead has pledged to price future medicines at parity with other key developed markets and to launch a Direct‑to‑Patient Program for Epclusa, its curative hepatitis C regimen. US patients with a prescription will be able to obtain Epclusa at a discounted cash price via TrumpRx.gov, which will connect them directly to Gilead’s internal access program, while the company secures a three‑year exemption from Section 232 tariffs in exchange for further US manufacturing investment.

Bristol Myers Squibb: free Eliquis for Medicaid and 80% discounts on select brands

Bristol Myers Squibb’s agreement centers on Eliquis (apixaban), the most widely prescribed oral anticoagulant in the US, used by more than 15 million Americans since launch for stroke prevention in non‑valvular atrial fibrillation and for the treatment and secondary prevention of venous thromboembolism. From 1 January 2026, BMS will provide Eliquis free of charge to the Medicaid program, a step that is expected to generate substantial savings for federal and state budgets and lower out‑of‑pocket costs for low‑income patients.

For every 100,000 patients treated, Eliquis has been associated with an estimated $3 billion in total healthcare cost avoidance by reducing hospitalizations and extended rehabilitation needs. To meet the administration’s four priority areas, BMS will donate more than seven tons of Eliquis API to the US Strategic Active Ingredient Reserve, commit to more balanced launch pricing across developed markets and enable direct‑to‑patient access at roughly 80% off current list prices for Sotyktu (deucravacitinib), Zeposia (ozanimod), Reyataz (atazanavir), Baraclude (entecavir) and Orencia SC (abatacept).

Amgen: AmgenNow expansion and large US manufacturing build‑out

Amgen’s actions with the US government extend an earlier understanding that satisfied the pricing components in President Trump’s July 31 letter, including Most Favored Nation requests. The company is expanding its AmgenNow direct‑to‑patient platform, which already offers the PCSK9 inhibitor Repatha at a monthly cash price of about $239, roughly 60% below its US list price for eligible patients, including those who are uninsured or on high‑deductible plans.

Under the new agreement, AmgenNow will add Aimovig (erenumab‑aooe) and Amjevita (adalimumab‑atto), both priced at $299 per month, representing discounts of nearly 60% and 80% respectively compared with current US list prices. Since 2018, Amgen has invested more than $40 billion in US manufacturing and R&D, supported by the Tax Cuts and Jobs Act of 2017 and the One Big Beautiful Bill Act of 2025, and it has announced a further $2.5 billion in US capital projects – including around $900 million in Ohio and $1 billion in North Carolina – in return for three years of relief from industry‑specific tariffs.