Group 1 - The core action taken by President Trump involves demanding 17 leading global pharmaceutical companies to propose concrete plans to lower drug prices in the U.S. within 60 days, or face government intervention [3] - Trump's letter emphasizes the implementation of the "Most Favored Nation" pricing policy, which aims to link U.S. drug prices to lower prices in other countries [3] - According to RAND Corporation, the average price of prescription drugs in the U.S. is typically 2-3 times higher than in other developed countries, and can be up to 10 times higher in some cases [3] Group 2 - Following the pressure from the government, some pharmaceutical companies, such as AstraZeneca, have begun to adjust their strategies by announcing price reductions for certain drugs in the U.S. [4] - Companies like Eli Lilly, Novo Nordisk, and Pfizer are exploring direct sales models as a response to the ongoing pricing pressures [4] - The pharmaceutical industry is preparing for potential tariffs on imported drugs, indicating that the pricing issue is part of a larger political and corporate struggle [4]

Core Viewpoint - The article discusses the potential impact of Trump's proposed drug pricing policies on the U.S. pharmaceutical industry, suggesting that while there are significant threats, the short-term effects may be limited due to existing structural challenges in the industry [1][2]. Group 1: Background and Current Situation - U.S. pharmaceutical spending is at a high level, with per capita drug spending reaching $1,564 in 2022, significantly higher than other developed countries. The compound annual growth rate (CAGR) from 2018 to 2022 was 6.2% [1]. - The increase in drug prices is primarily driven by innovative drugs, which have long-term pricing above inflation, while generic drugs continue to decrease in price. The complex pricing system supports the stability of high prices for innovative drugs [1]. - The U.S. pharmaceutical trade deficit is expanding, with imports projected at $213 billion and a deficit of $118.6 billion in 2024. Ireland has become a major source of this deficit due to tax advantages [1]. Group 2: Policy Implications - Trump's proposal for a "Most Favored Nation" (MFN) pricing policy aims to anchor U.S. drug prices to the lowest prices in developed countries, potentially reducing prices by 30%-80%. However, legal complexities may hinder its implementation, and the focus will likely remain on reforms within the Medicare framework [2]. - The Pharmacy Benefit Manager (PBM) system is identified as a structural monopoly that drives up drug prices, with rebate percentages for chronic diseases exceeding 50% and some reaching 80%. The top three PBMs control 80% of prescriptions, leading to a highly concentrated market [3]. - Trump's proposed 25% tariffs on European drugs aim to encourage domestic manufacturing, but the high costs and long construction timelines for U.S. production facilities may limit the effectiveness of this strategy in the short term [3].