By Rachel Cohrs Zhang
The US Department of Health and Human Services will get a portion of the increased revenue if Pfizer Inc. is able to charge higher drug prices abroad, according to newly released documents.
The “most favored nation” contract was released on Saturday by the consumer watchdog organization Public Citizen, which obtained it after filing a Freedom of Information Act lawsuit. The group released documents related to the Pfizer and Eli Lilly & Co. contracts, though the rest of the more than two dozen deals remain confidential.
The release provides additional detail about how the Trump administration’s drug-pricing policy fits in with broader trade negotiations.
Pfizer agreed to share a portion of its net increased revenue from charging higher prices abroad with HHS, the contract shows. The provision applies to medicines already on the market and is effective from Jan. 1, 2026, through Jan. 20, 2029. The rate of revenue sharing, included medicines and other details are redacted.
The redactions make it unclear if Eli Lilly agreed to similar terms.
“President Trump has been very clear that this is not a one-way street: Foreign prices are going to increase and American patients are no longer going to solely bear the burden of funding global innovation,” White House spokesperson Kush Desai said in a statement. “The foreign-revenue provisions are intended to ensure incremental revenue from higher prices abroad benefit American patients, not drugmakers.”
Pfizer spokesperson Amy Rose said the company stands “by our belief that the agreement Pfizer voluntarily reached with the administration last September is a win for American patients” and achieves priorities to lower prices for patients, redistribute global research and development costs, and create a predictable investment environment.
It’s unclear what HHS plans to do with the money. The contract states that the money will be used “for the purpose of lowering costs for US patients and taxpayers,” but provides no additional detail.
“Now, other countries are paying more so that Americans can pay less. We had to get their prices up in order to get our prices down,” President Donald Trump said during a recent Oval Office event touting some of the deals with drugmakers.
The initial White House fact sheet on the Pfizer deal released last year stated that Pfizer is required to “repatriate increased foreign revenue on existing products that Pfizer realizes as a result of the President’s strong America First U.S. trade policies for the benefit of American patients.”
The US and UK in December reached a trade agreement to allow tariff-free imports of medicines in exchange for a significant reduction in rebates drugmakers pay to the UK’s National Health Service. Under the agreement, the UK government will boost spending on medicines by 25%.
