Trump Signs Executive Order to Import Cheaper Medications

Hand signing a document on a wooden table

President Trump takes bold action to cut prescription drug costs for Americans, signing an executive order that could save seniors hundreds of dollars annually while establishing a pathway for importing lower-cost medications from Canada.

Quick Takes

Trump’s executive order streamlines state importation of prescription drugs from Canada, where per-capita spending is 42% lower than in the U.S.
The order improves the Medicare Drug Pricing Negotiation Program, with initial lower prices for 10 drugs starting January 1, 2026.
Low-income patients will receive significant discounts on life-saving medications like insulin and injectable epinephrine.
The FDA approval process for generic and biosimilar medications will be expedited, potentially reducing drug prices by up to 80%.
New transparency requirements will address broker practices in the prescription drug supply chain.

Trump Targets High Prescription Drug Costs

On April 15, 2025, President Donald Trump signed an executive order aimed at tackling the persistently high cost of prescription medications in the United States. The comprehensive order builds upon efforts from his first term and establishes multiple pathways to reduce costs for American patients. At the White House signing ceremony, Trump emphasized his administration’s commitment to making medication more affordable, particularly for seniors and those dependent on life-saving prescriptions. The executive order includes provisions for importing lower-cost drugs from Canada, improving Medicare drug price negotiations, and increasing market competition through faster approval of generic alternatives.

The order specifically directs the Department of Health and Human Services to facilitate state importation programs from Canada to reduce prescription drug costs. Florida is currently the only state authorized to import medications from Canada under section 804 of the Food, Drug and Cosmetics Act, but that approval process took more than three years. Trump’s order instructs the FDA to improve the authorization process and encourages more states to apply, potentially creating significant savings for patients as analysis by KFF found U.S. per-capita spending on prescriptions is 42% higher than in Canada.

🚨 NEW: President Donald J. Trump just signed an Executive Order to expand on the historic efforts of his first term to lower prescription drug prices.

The Order directs the Department of Health and Human Services to take steps to significantly reduce drug prices for American…

— Rapid Response 47 (@RapidResponse47) April 15, 2025

Medicare Reforms and Insulin Price Reductions

A major component of the executive order involves reforming the Medicare Drug Pricing Negotiation Program, allowing Medicare to directly negotiate with pharmaceutical companies for better prices. The order aligns Medicare payments with actual drug acquisition costs, addressing current overpayments in the system. The initial round of lower prices for 10 commonly prescribed medications is set to begin January 1, 2026, potentially saving seniors hundreds of dollars annually on their prescriptions. This reform specifically targets high-cost medications that have seen dramatic price increases in recent years, often outpacing inflation.

“Today, President Donald J. Trump signed an Executive Order to expand on the historic efforts of his first term to lower prescription drug prices,” wrote The White House.

The order also directly addresses the high cost of insulin, which has been a financial burden for millions of diabetic Americans. Dr. Mehmet Oz has been directed to develop programs that could allow low-income and uninsured patients to receive insulin for as little as 3 cents per vial. This provision builds upon the Trump administration’s previous efforts to reduce insulin costs during his first term. The order additionally provides significant discounts on other life-saving medications, including injectable epinephrine, which is critical for those with severe allergies.

Increasing Competition and Transparency

The Trump administration’s order addresses structural issues in the pharmaceutical industry by streamlining the FDA approval process for generic and biosimilar medications. These lower-cost alternatives can reduce prices by up to 80% compared to brand-name drugs. Health and Human Services Secretary Robert F. Kennedy Jr. has been instructed to work with Congress on addressing industry incentives that currently favor the development of expensive large-molecule drugs over less costly small-molecule alternatives, which could create longer-term market corrections in drug pricing.

“President Trump is dedicated to creating a transparent, competitive, and fair prescription drug market for American consumers,” The White House wrote.

The executive order also takes aim at broker practices in the prescription drug supply chain by directing the Department of Labor to establish rules for disclosing broker fees and conflicts of interest. This increased transparency is designed to eliminate hidden costs and ensure patients receive the full benefit of negotiated discounts. While the executive order focuses on lowering costs through imports and improved negotiations, President Trump has separately indicated that pharmaceutical tariffs could be considered in the “not too distant future” as part of efforts to bring drug manufacturing back to the United States.