Since September, 16 major drug companies have inked deals with the Trump administration to lower prices. But in January — the time of year when pharmaceutical companies typically roll out price hikes — all 16 companies released higher list prices for some of their drugs.
The agreements, nicknamed "most favored nation" deals, were aimed at getting lower prices for American consumers and pushing other wealthy countries to pay higher prices for new drugs.
But drug companies, including the 16 that made deals, raised the prices of 872 brand-name drugs in the first two weeks of 2026, according to a new analysis by 46brooklyn, a drug price research firm.
The drugs with price hikes included medicines to treat cancer, heart failure and Type 2 diabetes. The price of some COVID shots also went up.
"The real truth serum is what's happening in the marketplace after those deals occur," says Antonio Ciaccia, CEO of 46brooklyn, a nonprofit that tracks the list prices of prescription medications. "January is prime time for list price changes on brand-name drugs. So in examining where we are today, we're pretty much in line with the last few years."
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The price increases came in at a median of 4% — the same as last year — despite the deals announced with fanfare by the Trump administration.
Pharmaceutical list prices are the starting point for negotiations with insurers and the middlemen known as pharmacy benefit managers. List prices play a role in which drugs insurers choose to cover and what the patient ultimately pays out of pocket at the pharmacy counter.
Asked about the price hikes and whether they break the terms of the deals, White House spokesperson Kush Desai said the list prices aren't important and that the specific discounts addressed in the deals are coming to state Medicaid programs and patients who want to pay cash for some prescriptions.
The White House announced Thursday that it was asking Congress to pass legislation to support its Great Healthcare Plan. During a press call, Dr. Mehmet Oz, who leads the Centers for Medicare & Medicaid Services, claimed the plan would "codify" what was in the individually negotiated drug company deals.
What we know about the deals
Details are hard to come by since the administration's deal documents haven't been made public.
During the press conferences, health and White House officials mentioned the companies had made commitments for Medicaid discounts — but that's something the program already gets, says Dr. Ben Rome, a health policy researcher at Brigham and Women's Hospital.
The deals also included pledges for future drugs to be launched at the same price in other wealthy countries as in the U.S. And some drugs will be made available at a discount to cash-paying customers — that is, those who are uninsured or not using their health insurance — through a new website called TrumpRx.gov.
But those efforts don't affect prices for a lot of the companies' products and most health care consumers and insurance plans.
"Those deals probably are not very important in terms of manufacturer drug pricing and the prices paid by most Americans for prescription drugs," says Rome.
Pfizer, which reached the first deal with the Trump administration in September, raised the prices of 72 products in January, according to 46brooklyn. They include a 15% increase on the price of its COVID shot.
New York-based Pfizer says its new price increases were modest, and necessary to invest in new medicines and address added expenses. In an email to NPR, the company also pointed out that while list prices have gone up, the prices that insurance companies actually wind up paying Pfizer, after various discounts and rebates paid to middlemen and other programs, have gone down.
Merck also raised prices on 18 products, including Isentress for HIV and Belsomra for insomnia, according to 46brooklyn's data.
The New Jersey-based company said in an email that it made these decisions "responsibly to reflect a product's clinical value to patients and the health care system." Asked about how the price increases fit into its agreement with the administration, Merck spokesperson Julie Cunningham said the "exact terms" are "confidential," but the company is working on "fairer global pricing."
Some drug prices went down
There were 18 big price cuts in the first few days of the year, according to 46brooklyn. That includes four drugs that were part of the first round of Medicare drug price negotiation — an initiative launched by the Biden administration as part of the Inflation Reduction Act.
The negotiations lowered some drug prices paid by Medicare, but many wondered whether that might also lead to lower prices for privately insured patients.
The new data holds some clues. Fiasp, an insulin product, got a 75% price cut in the commercial market, according to the 46brooklyn data. The drug's maker, Novo Nordisk, said it also cut the prices of other drugs, and its goal was to make them more affordable for patients.
AstraZeneca's Farxiga and Boehringer Ingelheim's Jardiance, both used for diabetes and heart failure, and the blood thinner Eliquis, made by Bristol Myers Squibb, also got price drops between 37% and 44%.
When a company decides to lower prices, it's due to a variety of factors and policies, but 46brooklyn's Ciaccia says, "Medicare drug price negotiations, I would argue, are the straw that broke the camel's back."
Dr. Ben Rome isn't sure he agrees with that analysis: "It's hard to sort of pin any one drug or any one situation on any one policy," he says. "But it's probably a confluence of factors that have led to some of these drug [companies] making that decision."
After the first round of negotiations in 2024, Medicare prices for 10 chosen drugs were reduced by 38% to 79%, with those discounts going into effect in January of 2026.
The new report presents a mixed picture of what happened to those drugs outside of Medicare: Four posted big drops in list price this month, four didn't have price changes and two had price increases.
Copyright 2026 NPR
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