Xin Lang Cai Jing·2026-02-12 10:36Core Viewpoint - Some pharmaceutical companies not included in President Trump's drug price reduction agreement are developing their own plans to avoid potential harsh tariffs and new pricing mechanisms [1][4]. Group 1: Companies Involved - As of now, 16 major pharmaceutical companies, including Pfizer and Eli Lilly, have reached agreements with the government after receiving price reduction directives [1][4]. - Many companies, approximately half of which are members of the Pharmaceutical Research and Manufacturers of America (PhRMA), have not yet been contacted by the government [1][4]. - Bayer's global pharmaceutical business head, Stefan Oelrich, expressed optimism that companies like Bayer, which did not receive directives, would have opportunities to reach similar agreements with competitors [1][4]. Group 2: Concerns of Smaller Companies - A group of mid-sized companies has formed the American Mid-Sized Biotechnology Alliance to oppose the new pricing mechanisms [2][5]. - Sanofi's CEO, Paul Hudson, noted that many companies have not reached agreements and questioned what options they have [2][5]. - Hudson also indicated that the nature of existing agreements might make it difficult for the government to offer similar options to smaller companies [2][5]. Group 3: Pricing Mechanisms and Implications - U.S. patients pay the highest prescription drug prices globally, often nearly three times higher than in other developed countries [3][6]. - Agreements signed by large pharmaceutical companies commit to lowering drug prices for Medicaid, but analysts suggest the impact may be limited since Medicaid accounts for only 10% of U.S. drug spending [3][6]. - Companies that have not reached agreements will face constraints from Medicare pilot programs, GLOBE and GUARD, which will implement most-favored-nation pricing, aligning U.S. drug prices with lower international prices [3][6]. - Concerns exist that mid-sized companies, having fewer products to negotiate, may not have low-revenue drugs to "sacrifice" in negotiations [3][6].