Trump Issues Ultimatum to Big Pharma: Cut Drug Prices or Face Federal Crackdown

The Trump administration has issued its sharpest warning yet to the pharmaceutical industry, demanding immediate reductions in prescription drug prices or risk sweeping federal intervention.

White House Press Secretary Karoline Leavitt announced Thursday that President Donald Trump personally sent letters to 17 major pharmaceutical CEOs, insisting they take action within 60 days to lower costs or face the full force of federal authority.

“The president’s patience has run out,” Leavitt told reporters during a press briefing. “For years, American families have been forced to pay more for the same medicines available overseas at a fraction of the cost. That ends now.”

The President’s Warning

According to the White House, the letters accuse drug companies of engaging in “abusive and exploitative pricing practices” that have burdened U.S. consumers. Trump vowed to use “every tool available” — including potential price controls and emergency powers — if companies do not act voluntarily.

Leavitt shared excerpts from one of the letters addressed to Eli Lilly CEO David Ricks, in which the president accused pharmaceutical firms of letting foreign nations “live off the backs of American patients” through skewed international pricing.

“For decades,” Trump wrote, “the United States has been subsidizing the world’s medicine cabinet. Other countries pay pennies on the dollar while our citizens bear the full cost. Those days are over.”

Key Demands to the Industry

The letters, now posted publicly on Trump’s Truth Social account, outline several expectations for the industry to meet within two months:

• Global Price Parity: U.S. consumers must be offered the same prices that drug companies charge in their lowest-cost international markets.

• Fair Launch Pricing: Newly approved drugs must enter the American market at a price equal to or lower than that of comparable foreign nations.

• Revenue Reinvestment: A portion of overseas profits must be reinvested in U.S. affordability initiatives and taxpayer relief programs.

• Direct Federal Purchasing: The federal government should be allowed to buy drugs directly from manufacturers at the most favorable global rates.

“If companies refuse to cooperate,” Trump warned, “we will act decisively to defend the American people from greed and indifference.”

From Executive Order to Enforcement Threat

The confrontation follows Trump’s May 2025 executive order that sought to cut prescription drug prices by as much as 80 percent through expanded federal negotiation and transparency mandates.

That order instructed the Department of Health and Human Services (HHS) to reach voluntary pricing agreements with major drug firms within 30 days. Yet, months later, the White House says progress has been minimal.

“Instead of reform, we received excuses,” Trump wrote. “Instead of solutions, we got proposals for subsidies and loopholes. The era of excuses is over.”

Leavitt added that the administration expects “substantial engagement” from pharmaceutical leaders before the deadline expires, but cautioned, “The clock is ticking.”

Industry Pushback

The pharmaceutical industry’s initial reaction has been cautious but defensive. In a brief statement, PhRMA — the leading trade association for drug manufacturers — reiterated its commitment to affordability while warning that government-imposed price controls could undermine innovation.

“We share the administration’s goal of improving patient access,” the group said, “but rigid price caps risk limiting future research, delaying lifesaving treatments, and reducing patient choice.”

Privately, several industry executives have expressed alarm over the prospect of federally mandated pricing, particularly Trump’s “most-favored-nation” provision, which would force American prices to match the lowest global rate for each product.

Economists note that such a shift could upend the international pharmaceutical market, where the U.S. currently accounts for nearly half of global prescription spending.

A Political and Public Flashpoint

Public opinion, however, appears squarely behind Trump’s initiative. A Pew Research survey earlier this year found that 83 percent of Americans — including large majorities of Democrats and Republicans — believe drug costs are unreasonably high.

With the 2025 election season underway, the White House has embraced the fight as a central campaign theme. Trump has framed the standoff as proof of his populist stance against entrenched corporate interests.

“Democrats had years to fix this and did nothing,” Trump posted on Truth Social. “We’re the only ones willing to take on Big Pharma — and we’ll win.”

A History of Confrontation

Trump’s clash with the pharmaceutical industry is not new. During his first term, he repeatedly accused drug makers of “global price gouging” and issued a series of executive actions designed to increase import competition and pricing transparency.

But this latest move marks an escalation — one that places the White House on a collision course with some of the world’s most powerful corporations.

“President Trump has made it clear that no company is too big to be held accountable,” Leavitt said. “If you’re profiting by exploiting American patients, expect consequences.”

What Comes Next

If companies fail to act within the 60-day window, administration officials have indicated that the president may pursue aggressive measures, including:

• Imposing temporary price caps on drugs purchased through Medicare and Medicaid.

• Authorizing states to import lower-cost medicines from Canada.

• Freezing approvals for new drugs until affordability benchmarks are met.

Such actions would almost certainly trigger legal challenges, but Trump’s aides insist he is prepared to push forward regardless.

“This is uncharted territory,” said Dr. Elaine Porter, a health policy analyst at the Brookings Institution. “If implemented, it could redefine how much control the federal government has over private-sector pricing.”

For now, the pharmaceutical industry faces an uncertain future — and a rapidly approaching deadline.

As one senior White House aide put it, “They’ve had years to talk about lowering prices. Now they have sixty days to prove they mean it.”