President Donald Trump’s most-favored-nation drug pricing campaign reached its biggest political milestone after Regeneron Pharmaceuticals became the final company among 17 major drugmakers targeted by the White House to strike a pricing deal.
The agreement requires Regeneron to lower Medicaid prices based on prices in other developed countries, align US prices for future medicines with prices set in that group of countries, and sell Praluent directly through TrumpRx.gov. Regeneron said it will also provide Otarmeni, its newly approved gene therapy for a rare form of genetic hearing loss, for free in the US.
The White House framed the Regeneron deal as the completion of a broader campaign launched after Trump publicly sent letters in July 2025 to executives at 17 major pharmaceutical companies which cover roughly 80% of the US branded drug market.
Regeneron’s most concrete patient-facing price cut involves Praluent, its cholesterol treatment. The drug will be offered on TrumpRx.gov for $225, down from a stated $537 monthly price for eligible direct purchasers, according to AP and White House materials.
The pharma also committed to spending $27.0 billion on US research, development, and manufacturing, while Trump’s drug pricing agreements have historically paired price concessions with tariff relief for companies making domestic investment commitments. Reuters reported earlier this month that the companies agreed to MFN pricing and TrumpRx participation in exchange for three-year exemptions from tariffs on drug imports.
The second headline item is Otarmeni, also known as lunsotogene parvec-cwha, which the FDA approved on April 23 as the first dual adeno-associated virus vector-based gene therapy for OTOF-related severe-to-profound and profound sensorineural hearing loss. The FDA said the approval came 61 days after the biologics license application was filed, tying it for the fastest BLA approval in modern FDA history.
Regeneron said Otarmeni is indicated for pediatric and adult patients with molecularly confirmed biallelic variants in the OTOF gene, preserved outer hair cell function, and no prior cochlear implant in the same ear. The company said its pivotal CHORD trial showed 80% of participants achieved or surpassed the primary endpoint hearing level, while 42% achieved normal hearing that included whispers after longer follow-up.
The free gene therapy pledge is clinically significant but commercially narrow, since eligibility depends on a rare genetic diagnosis and specific medical criteria.
Health and Human Services Secretary Robert F. Kennedy Jr. used the event to argue that Americans have funded much of the world’s pharmaceutical innovation while paying higher drug prices than patients abroad. That is the political core of the MFN model, which seeks to tie US prices to the lowest prices paid in selected peer countries.
The confirmed deals, however, are not the same as a universal price cap across the entire US drug market. AP reported that full agreement details have not been made public, and Kennedy told members of Congress this week that HHS would share what it could without disclosing proprietary information or trade secrets. Trump and Kennedy have also urged Congress to codify the agreements into law.
There is also scrutiny around the FDA’s Commissioner’s National Priority Voucher program, which accelerated Otarmeni’s review. AP reported that the program was not authorized by Congress and has drawn questions from Democratic lawmakers, who have noted that vouchers have repeatedly gone to companies that agreed to pricing concessions sought by the White House.
Nevertheless, the stock reaction suggests investors did not read the agreement as a sweeping hit to Regeneron’s economics. Shares rose after the announcement by 2.6%.
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