A new analysis suggests that efforts by the Trump administration to reduce prescription drug spending in the United States may inadvertently create a powerful incentive for pharmaceutical companies to raise prices and limit access to medicines in other nations. The administration has sought to align prices under the federal Medicare program with those paid by other wealthy countries, but researchers found that for roughly three-quarters of the drugs studied, potential revenue losses from lower Medicare prices would outstrip all sales generated in the lower-priced countries used as new benchmarks.

Published Sunday in the Lancet, the study indicates that drugmakers might respond by increasing prices in some markets or withdrawing from them altogether. This dynamic has already begun to emerge, with several companies citing the US pricing policy as leverage in negotiations elsewhere. Astellas Pharma, for instance, secured a higher price for a new eye medication in Japan this year, explicitly referencing concerns over the US approach. In Europe, some firms are scaling back their plans.

Biogen's chief executive, Chris Viehbacher, noted this year that the company would launch its postpartum depression treatment Zurzuvae in only a few European countries, while Roche Holding has suggested it might never introduce an unapproved breast cancer pill in its home market of Switzerland. The study, conducted by researchers at Brigham and Women's Hospital, examined 195 patented drugs that accounted for $87.9 billion in Medicare spending in 2024.

By estimating the actual payments made by the program after confidential rebates and discounts, and comparing them to 19 reference countries, the team calculated that aligning Medicare prices with those benchmarks would save the US government $11.6 billion across two pilot programs. However, if the 17 companies that have already reached separate pricing agreements with the White House were exempted, those savings would drop to $3.3 billion. Nine additional drugmakers struck pricing deals with the government earlier this month, though those agreements were not included in this analysis.