Donald Trump signed the executive order on prescription drug prices on May 12, 2025, aiming to implement a “most favored nation” (MFN) pricing model to align U.S. drug prices with those in other developed countries.
The order directs the Department of Health and Human Services (HHS) to set price targets within 30 days—by June 11, 2025—and requires “significant progress” toward those goals within six months, which would be around November 12, 2025.
However, the timeline for when the policy might actually take effect and lead to lower drug prices for Americans is far less certain due to several factors.
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First, the order relies on voluntary compliance from drugmakers initially, with HHS tasked to negotiate price reductions. If drugmakers fail to meet these targets, HHS is directed to propose rulemaking to enforce MFN pricing, which could take months or even years.
Rulemaking typically involves drafting proposals, a public comment period (often 30–60 days), revisions, and finalization, which can stretch the process to 6–12 months or longer, especially for a policy this complex. For comparison, Trump’s 2020 MFN policy for Medicare Part B drugs was finalized in late 2020 but never took effect due to court challenges and was rescinded by Biden in 2021, illustrating the potential for delays.
Legal Challenges
Second, legal challenges are almost guaranteed. The pharmaceutical industry, represented by groups like PhRMA, has historically opposed MFN pricing, arguing it threatens profits and innovation. Experts, including Lawrence Gostin from Georgetown Law, predict a “flood of litigation” once concrete actions are taken, which could delay implementation further. The 2020 MFN rule was blocked by federal courts for procedural reasons, and this broader order—covering Medicare, Medicaid, and private insurance—may face similar or stronger resistance. Litigation can take months to years to resolve, potentially stalling the policy well beyond 2025.
What Drugs?
Third, the order’s scope and implementation details remain vague. It doesn’t specify which drugs are targeted (though weight-loss drugs like Ozempic are expected to be included) or how prices will be enforced in the private market, where HHS has limited authority.
This ambiguity could slow down the process as agencies work out logistics, potentially requiring congressional approval for certain aspects, which adds another layer of uncertainty.
How long?
Even if rulemaking proceeds smoothly, historical precedents suggest price reductions wouldn’t be immediate. For instance, the Inflation Reduction Act of 2022 allowed Medicare to negotiate prices for a small number of drugs, but those negotiated prices don’t take effect until January 2026—over three years later.
A similar timeline here could mean noticeable price changes might not occur until mid-2026 or later, assuming no major legal or legislative roadblocks.
Trump’s claims of “almost immediate” reductions of 30–80% (or even 90%) are widely disputed by experts. Arthur Caplan from NYU Langone Medical Center called such immediate cuts “impossible,” and analysts like Chris Meekins from Raymond James noted that Trump’s grandiose promises often outstrip what policies can deliver, especially given likely court challenges.
At best, some preliminary effects might be seen in late 2025 for certain Medicare drugs if drugmakers voluntarily comply, but broader impacts across all markets are more likely to take 1–2 years, if the policy survives legal scrutiny.
Final Analysis
In summary, while the executive order sets a 30-day deadline for price targets (June 11, 2025) and a six-month progress check (November 12, 2025), actual price reductions are unlikely before late 2025 or more realistically 2026, due to rulemaking, legal challenges, and implementation hurdles.
The establishment narrative of swift action should be viewed skeptically, as structural and legal barriers make rapid change improbable.
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