Sen. Reuben Gallego (D-Ariz.) expressed worries regarding the vague details surrounding Trump’s “most favored nation” (MFN) pricing agreements, urging the CEO of Pfizer to clarify the implementation plans for the contract.
In a letter to Pfizer’s CEO Albert Burla, shared with The Hill, Gallego called for a transparent agreement with the Trump administration.
Burla stated at the White House on Tuesday that the company would adhere to the four requests outlined in the MFN executive order signed in May.
These requests included offering priority pricing for all Medicaid patients, providing better drug prices to other developed nations, creating direct sales options for consumers, using trade policies to adjust international prices, and ensuring revenues are reinvested to lower prices in the U.S.
Gallego noted that no specifics about the transaction have been made public, questioning how the agreement, advertised by the White House as beneficial for patients, would actually play out. He pointed out that neither the administration nor Pfizer disclosed which drugs are included, the agreed-upon prices, or how patients would benefit.
“A press release from Pfizer mentioned that ‘certain terms of the agreement remain confidential,’ which raises serious concerns,” he added.
The senator inquired about the data that would inform the MFN formula, including which countries would be factored in for price setting, and whether Pfizer was transparent in its pricing methods.
Gallego also asked how frequently prices would be updated and how many Medicaid-eligible drugs would qualify for MFN pricing.
Chris Cromp, director of Medicare, mentioned on Tuesday that Pfizer is expected to provide MFN pricing for “virtually all of the drug portfolio” soon for Medicaid recipients.
Gallego raised concerns about whether Pfizer might shift costs to other markets like private insurers or employer-sponsored plans, asking if MFN pricing would extend to commercial insurance and Medicare Part D.
He requested additional information about Pfizer’s involvement in the Trumprx platform, noting that patients would need to pay cash for medications, potentially negating the benefits since insured individuals might have lower co-pays or coinsurance than the proposed TrumPRX discounts. “It could, in fact, raise costs for patients,” he suggested.
Senior officials did not confirm whether insurance options would be available on Trumprx.com, expected to launch early next year.
On Tuesday, Burla indicated that Pfizer was shielded from tariffs under its contract with the White House and stated that Trump received a “three-kind” regarding the 232 tariffs.
Previously, Trump had threatened to impose 100% tariffs on drugmakers that had not established facilities in the U.S. since October 1, but the administration has since decided to allow more time for negotiations.
Burla emphasized the importance of the U.S. price framework, stating, “I read President Trump’s letter, noted the four points, and this is the framework which we adhere to regarding how prices are set in the U.S. and abroad.”
The Hill reached out to Pfizer for comments regarding Gallego’s letter.
