Prescription Drug Management

The Trump administration continues to advance its commitment to lowering prescription drug prices, centered on a revived “Most-Favored-Nation” model. A recent executive order directs federal agencies to benchmark U.S. drug prices against the lowest prices paid in comparable countries, while also expanding direct purchasing and drug re-importation programs. To further pressure manufacturers, the administration has threatened steep tariffs on imported pharmaceuticals.

At the state level, legislatures have introduced over 800 bills in 2025 to improve prescription access and reduce consumer costs. These proposals include capping out-of-pocket expenses, regulating pharmacy benefit managers (PBMs), supporting state affordability boards, and addressing high-cost therapies and pricing trends. An overview of state efforts is available in the National Conference of State Legislatures’ (NCSL) summary.

While state initiatives focus on consumer protections and targeted regulatory reforms, the federal strategy under the Trump administration leans heavily on international price comparisons, trade leverage, and structural market changes. We can only hope these combined efforts will eventually lead to more affordable prescription drugs.