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Fortune | FORTUNE

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White House estimates Trump's Big Pharma dealmaking will ...
Josh Boak, T · 2026-05-06 · via Fortune | FORTUNE

White House economists estimate that President Donald Trump’s deals with pharmaceutical companies to drop some of their U.S. prescription drug prices to what they charge in other countries could save $529 billion over the next 10 years.

The analysis obtained by The Associated Press includes the first economy-wide projections behind a policy at the core of Trump’s pitch to voters going into November’s midterm elections for control of the House and Senate. Democratic lawmakers have been doubtful about the savings claimed by Trump and these new numbers are likely to trigger additional questions about the data.

Cost-of-living issues are at the forefront of voters’ concerns and higher energy prices tied to the Iran war have deepened the public’s anxiety. Trump has tried in part to address affordability concerns by focusing on his efforts to cut deals with companies so that the cost of prescription drugs in the U.S. would no longer be dramatically higher than in other affluent nations.

“Now you have the lowest drug prices anywhere in the world,” Trump said at a Friday rally before a crowd of seniors in Florida. “And that alone should win us the midterms.”

The analysis was done by administration officials for the White House Council of Economic Advisers. They also estimated that federal and state governments could save a combined $64.3 billion on Medicaid during the next decade because of what Trump calls his “most favored nation” policy on drug prices.

Few of the details of the deals struck by the Trump administration and 17 leading pharmaceutical companies have been made public, making it hard to independently verify the projected savings. The White House analysis sought to estimate the prospective savings as more medications come onto the market and fall under Trump’s framework — with one model in the report tallying the possible savings at $733 billion over a decade.

Trump and his Department of Health and Human Services have touted his drug-pricing deals as transformative and urged Congress to codify their principles into law. Democratic lawmakers have challenged the administration’s claims of savings. Senate Finance Committee Ranking Member Ron Wyden, D-Ore., and 17 Senate Democrats in April proposed a measure requiring the administration to disclose the terms of the agreements signed by pharmaceutical companies.

“If these deals are so great, why is the Trump administration afraid of showing them to the public?” Wyden said when announcing the measure. Health Secretary Robert F. Kennedy Jr. said his team would share details that didn’t include proprietary information or trade secrets.

The White House said it has not shared the text of the agreements because they include highly sensitive data that could move financial markets.

The potential savings estimated by the Trump administration would be substantial as Americans spent $467 billion on prescription drugs in 2024, according to the most recent government data available. The analysis is premised on the idea that foreign countries would also pay more for their prescription drugs, which would diversify drugmakers’ sources of revenue and preserve their ability to innovate with new treatments.

Outside economists have caveated that any savings might not flow directly to patients, many of whom already pay discounted prices for their drugs through their insurance coverage.

The Congressional Budget Office in October 2024 estimated that a plan similar to what Trump ended up adopting could reduce prescription drug prices by more than 5%, though the decrease “would probably diminish over time as manufacturers adjusted to the new policy by altering prices or distribution of drugs in other countries.”

The scope of the savings claimed by the Trump administration are likely to intensify the scrutiny by Democrats, who counter that any price reductions would be offset by higher costs for prescription drugs not covered by the “most favored nation” framework. One of their main critiques is that pharmaceutical companies have increased their profit margins while working with the administration.

In April, staff working for Sen. Bernie Sanders, I-Vt., released an analysis that looked at 15 of the companies that have agreed to this drug-pricing plan and found that their combined profits jumped 66% over the past year to $177 billion. The report noted that the tax cuts Trump signed into law last year “exempted or delayed many of the most expensive drugs” from price negotiations with Medicare.

The Trump administration has countered that they consider Sanders’ critique to be flawed, saying that it’s based on the list prices for pharmaceutical drugs instead of the actual price that patients pay.