Name: Trump's Drug Cost Executive Order
Uploaded: 2025-05-18T14:01:00Z
Duration: 5 min 28 s
Description: Journal Editorial Report: What is the cost for drug innovation?

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Journal Editorial Report: What is the cost for drug innovation? Photo: Andrew Harnik/Getty Images

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Journal Editorial Report: What is the cost for drug innovation?

Trump's Drug Cost Executive Order

Some prescription drug and pharmaceutical prices will be reduced almost immediately by 50 to 80 to 90%. Big Pharma will either abide by this principle voluntarily, or we'll use the power of the federal government to ensure that we are paying the same price as other countries.

President Trump signed an executive order this week that he says will lower prescription drug prices in the US, which are costlier than most other developed nations. The order directs federal agencies to encourage drug makers to voluntarily lower prices over a 30 day period or face potential regulations. And it has some Republicans scrambling to stay on message. Senate Majority Leader John Thune said Monday the price plan would be fairly controversial if it were done legislatively. What would the effect of this policy be for new medical cures? Our panel is back. So Allysia, in practical terms, what is the president proposing to do? It's called Most Favored Nation price controls. What would it do?

Well, he's proposing to require drug makers to give the US government and potentially other private insurers, their drugs at the same cost that they offer them to the lowest or to other low-income countries or economically developed countries that charge very low rates. So what would happen, or this is the way his executive order suggests, is that if they refuse to give the government their drugs at that price, then the government might come in and threaten to yank their FDA approvals, could also start antitrust or anti-competitive investigations into the drug makers, block their exports to other countries and take a whole host of options. So this is essentially pointing a gun at the drug makers' heads.

Yeah, it doesn't sound like voluntary at all. It sounds like, you know, the basically mob tactics you take, is an offer you can't refuse, Allysia.

That's exactly right. And I think one of the reasons they're doing it this way is because they know it's unconstitutional. This would violate the Supreme Court's major questions doctrine. And so they're trying to do it basically under the table, saying, give us this or else. But I think this drug makers could eventually actually have a strong argument that that is essentially extortion.

Kate, so the president is trying to do this because I guess by executive order, because there's real question about whether Congress would come close to passing this, as John Thune suggested. There isn't even a rulemaking here yet, so it's hard to challenge. Do you think this could pass Congress?

I don't think it could pass Congress. There has been some effort to get a provision like this into the big beautiful bill we were just discussing. But the reason, Paul, it's gonna have trouble in Congress is because Congress understands that, yes, Europeans freeload on American drug innovation, but Americans get new drugs much faster and first other than other nations. When you look at new drugs, I mean about 90% of them are available in America right away versus months or years delay in some of these single-payer systems. That really matters if you are someone with cancer and autoimmune disease. And that's why we shouldn't be so quick to just give up this big advantage we have, even if Europe free rides off of it.

Yeah, Kyle, there's a contradiction here, it seems in the president's policy. The one hand he talks, and I think rightly so, but faster cures, we're gonna do more to expedite some drug approvals, and we've got all of this great new innovation and drugs with genetic medicine and the personalized medicine and biologics. On the other hand, we're gonna say, you can't charge what, you're gonna have to charge what we think, which is going to reduce capital investment. It's going to reduce venture capital, and it's going to reduce a new startups.

Right, I mean, you're essentially talking about importing other countries price controls. I would extend the contradiction in Trump's thinking here because there's a pretty good argument that some of these countries are freeloading off of US medical innovation. But then why don't we pick a fight with them about that? Why are we putting tariffs on the UK, which we have a trade surplus with. Why are we fighting with the EU about giving us Greenland? Why don't we pick some of these trade fights in a way that would make a difference? The the downside here is not only that if you import the price controls like he's talking about, there's gonna be all sorts of cures that are never developed and big incentives I think for these pharma companies to take their business elsewhere, maybe get their intellectual property off of US soil.

And, Allysia, the the Chinese are really moving very quickly when it comes to biological innovation. They're still behind us, but there's a sense that they're catching up fast. What impact would this have on that Chinese-US competition?

Well, I think you're right. You're seeing the Chinese go into other mRNA CAR T-cells that the US pioneer. And what's happening is that the US is starting to fall behind, and some members of Congress are now even raising the prospect of subsidizing US drug makers and biotech to keep pace with the Chinese. So when you reduce private investment and which is typically how US innovation has been actually developed is through private investment, you are gonna see a retarding effect on innovation in the US.

WSJ Opinion: Trump's Drug Cost Executive Order

From the award-winning opinion pages of The Wall Street Journal, the Journal Editorial Report sees columnists and members of the Journal Editorial Board debate the major economic, political and cultural issues of the day. 
From the policy debates to the political fights, each week get critical perspective and the analysis you need on developments from Washington.

WSJ Opinion: Trump's Drug Cost Executive Order

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