The stark difference in pharmaceutical costs between the United States and European nations was a central point of discussion recently, as President Donald Trump addressed a gathering of global executives and leaders. He remarked that a prescription that might cost $10 in London could command a price of $130 in American cities like New York or Los Angeles, an observation that drew murmurs from the audience. This disparity underscores a long-standing debate concerning drug affordability and the varied pricing structures across international markets.
Trump, speaking at the World Economic Forum, expressed his affection for Europe but voiced concerns about its current trajectory, noting that friends visiting the continent often tell him it feels unrecognizable, “and not in a positive way.” Yet, he readily acknowledged Europe’s distinct advantage in managing drug prices. This point aligns with broader research findings, such as a 2024 Rand study which concluded that consumers in the U.S. paid nearly three times more for drugs on average compared to those in 33 other countries, including France, Germany, and the United Kingdom, in 2022.
During his presidency, Trump pursued initiatives aimed at reducing domestic drug costs, including the adoption of a “most favored nation” policy. This strategy sought to lower prices for American consumers while simultaneously pressuring other nations to contribute more to pharmaceutical development. A significant effort involved a reported deal with 17 pharmaceutical companies, aiming to align U.S. drug prices with international rates. He alluded to a recent executive order, signed just the previous week, intended to slash drug prices by as much as 90 percent.
The former president recounted a conversation with French President Emmanuel Macron, where he allegedly urged Macron to increase drug prices in France. Trump stated that threatening a 25 percent tariff on French goods, including wines and champagne, ultimately secured the agreement. However, Macron’s office publicly disputed this account, asserting that the French president does not control drug prices, which are regulated by the social security system and have remained stable. An X post from Macron’s office even included a “Fake news!” graphic overlaid on an image of Trump, further highlighting the disagreement.
Health policy experts frequently attribute the elevated drug prices in the U.S. to a unique system where pharmaceutical companies negotiate with numerous individual insurance providers or pharmacy benefit managers. This fragmented negotiation landscape often grants companies greater leverage to set higher prices, unlike systems in other countries where a single regulatory body negotiates on behalf of an entire population. This structural difference creates a significant economic divergence in drug accessibility.
Despite the former president’s efforts and the potential for industry-wide shifts, early indicators suggest that drug prices have not seen a significant reduction. A January report from 46brooklyn, a drug price research firm, found that many pharmaceutical companies, including 16 of the firms involved in Trump’s deals, raised prices on some drugs in the initial weeks of 2026. The median increase for 872 brand-name drugs was approximately 4 percent, consistent with the previous year’s rate. Similarly, Reuters, citing data from 3 Axis Advisors, reported earlier this month that the 17 drug companies had increased prices on 350 medications. Public health experts have suggested these increases are due to the opaque nature of deals between drug companies and insurers. Dr. Benjamin Rome, a health policy researcher, commented that such deals often “nibble around the margins” rather than addressing the core drivers of high prescription drug costs in the U.S.
