Pharmaceutical companies that signed pricing agreements with President Trump have continued raising costs on hundreds of medications, undercutting his central promise to lower prescription drug expenses, according to a new Senate Democratic report.
The report, released Thursday by Sen. Bernie Sanders as ranking member of the Senate Health, Education, Labor and Pensions Committee, documents aggressive price increases across major drug categories. Companies party to Trump's deals launched new treatments at an average annual price of $353,000 and jacked up list prices on existing drugs even as negotiations were underway.
"American people continue to pay by far the highest prices in the world for prescription drugs," Sanders said at a hearing on the findings. "In most cases, it is even more accurate today."
The profitability gap tells the real story. Drugmakers that signed Trump deals hauled in $177 billion in combined profits during 2025, nearly double the $107 billion they made the previous year. That surge occurred precisely when the companies were publicly committing to price restraint.
Merck's Keytruda, a blockbuster cancer treatment, climbed 6 percent to roughly $210,000 annually in the U.S. Japanese patients pay $37,900 for the same drug. French patients pay $88,100. Novartis raised its multiple sclerosis medication Kesimpta by nearly $10,500 to $141,000 yearly, while the German price sits at $17,300 and Canada's at $23,500.
Bristol Myers Squibb's immunotherapy Opdivo jumped 4 percent to $260,000 per year, more than double what patients in France and the United Kingdom pay.
The report spotlights an uncomfortable reality about Trump's "most favored nation" deals: they lack teeth and transparency. The White House publicized the agreements but disclosed few substantive details. It remains unclear which specific drugs fell under the deals' scope, though all major drugmakers involved were identified.
Stacie Dusetzina, a health policy professor at Vanderbilt University, framed the core problem bluntly. "One of the more frustrating aspects of recent drug pricing announcements has been the lack of transparency into the so-called deals that are being made by the administration," she said. "In fact, once you dig into the details, it appears that the administration's efforts to date have mostly served to help drug companies."
The White House pushed back by arguing that list prices are a distraction. Spokesman Kush Desai said Sanders' report "fixates on prescription drug list prices, which are meaningless because they do not reflect the actual purchase prices that patients pay at the pharmacy counter." Under the deals, companies offered some discounts on a new platform called TrumpRx.gov for cash-paying customers, with many discounts matching those already available on GoodRx.
But the mechanics matter. While patients may receive discounts, higher list prices allow drugmakers to charge insurance companies more. Those elevated insurance costs eventually translate to higher premiums and deductibles for everyone else.
Several newly launched medications carry astronomical price tags. Johnson & Johnson's cancer drug Inlexzo entered the market at roughly $1 million annually. AbbVie's Emrelis costs about $719,000 per year. AstraZeneca's Datroway runs approximately $419,000. Novartis' Itvisma, a one-time gene therapy for spinal muscular atrophy, carries a list price exceeding $2.59 million.
Novartis also increased Zolgensma, another spinal muscular atrophy gene therapy, by nearly $200,000 to more than $2.5 million for a single treatment course. Pfizer raised its lung cancer drug Vizimpro by roughly 5 percent to about $208,000 annually.
Antonio Ciaccia, CEO of 46brooklyn, a nonprofit tracking U.S. drug pricing, said companies signing Trump deals never committed to lowering prices across their entire product portfolios. For excluded drugs, he noted, "it's been business as usual and this year is no different." He credited a modest decline in brand-name list prices during 2026 not to Trump administration action but to Biden-era policies, particularly Medicare drug pricing negotiations.
Health Secretary Robert F. Kennedy Jr. is preparing to testify before Congress on Thursday on Trump's budget priorities, including drug cost reduction. The timing underscores mounting scrutiny of whether these vaunted deals will produce anything substantive for patients or merely serve as cover for industry as prices continue climbing.
Author Sarah Mitchell: "The gap between Trump's price-control rhetoric and industry behavior under his deals reveals a familiar Washington pattern: companies pocket the wins while patients foot the bill."
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