Lowering Drug Prices By Once Again Putting Americans First

The changes target what patients, employers, Medicare, Medicaid, and taxpayers pay for medicines while seeking to preserve pharmaceutical innovation.

What the order does ​

• Revises Medicare drug-negotiation guidance to prioritize high-cost drugs, improve transparency, and limit harm to domestic innovation.
• Directs development of a Medicare payment model for high-cost drugs and recommendations to reduce Part D premiums.
• Calls for legislation aligning negotiation rules for small-molecule drugs and biologics without raising Medicare costs.
• Orders reviews of hospital outpatient drug costs and payment incentives that may favor hospitals over physician offices.
• Seeks more accurate Medicaid rebates, value-based drug payments, and stronger state drug-spending tools.
• Conditions certain health-center grants on offering discounted insulin and injectable epinephrine to qualifying low-income patients.
• Directs faster approval of generics, biosimilars, combination products, and competing brand-name drugs, plus easier prescription-to-over-the-counter switches.
• Streamlines state applications to import lower-cost drugs while maintaining safety and quality requirements.
• Requires proposed transparency rules for pharmacy benefit manager compensation to employer health plans.
• Orders recommendations addressing pharmaceutical supply-chain inefficiency and anti-competitive manufacturer conduct.

Who it affects ​

• Medicare and Medicaid beneficiaries, including seniors enrolled in Medicare Part D.
• Low-income, uninsured, and underinsured patients needing insulin or injectable epinephrine.
• States, community health centers, hospitals, physician offices, employers, and employer health plans.
• Drug manufacturers, pharmacy benefit managers, importers, and developers of generic and biosimilar medicines.