For a year the administration has announced “most favored nation” pricing deals with drugmakers without releasing any of them. On September 19, 2026, the first contract text became public: heavily redacted agreements with Pfizer and Eli Lilly that the watchdog group Public Citizen obtained through a Freedom of Information Act lawsuit and shared with The Washington Post. The Post reported that the deals “include inducements to raise drug prices overseas and promise protection from President Donald Trump's tariffs.”
The documents themselves are posted, and several terms can be read directly. In a September 30, 2025 letter signed by Commerce Secretary Howard Lutnick and Pfizer's chief executive, the government commits that until January 1, 2029, “Commerce will not impose Section 232 Tariffs” on the pharmaceutical products and ingredients Pfizer imports, in exchange for Pfizer spending a redacted sum on U.S. manufacturing. That signers would get tariff relief was public from the start; the wording and duration were not. The health department's agreement with Pfizer says “Pfizer agrees to share with HHS” a redacted portion of any added revenue it earns from raising prices abroad, which means the government holds a financial stake in higher foreign prices. The size of the share is blacked out.
Other clauses describe who is in charge. HHS “represents and warrants that this Agreement provides an unmistakable promise that it shall take all regulatory, administrative, and other actions necessary” to carry it out. The prices at the center of the deal are calculated “using good faith, reasonable assumptions as determined by Pfizer.” Pfizer may terminate immediately under conditions that are redacted. And on disclosure: “HHS will treat all Confidential Information as exempt from release under FOIA.”
The timeline also differs from the announcements. The paper signed at the White House event on September 30, 2025 was, in its own words, “intended only to create the obligation between the parties to engage in diligent and good faith negotiations” toward a later agreement. The binding contract was signed on February 23, 2026, nearly five months after the deal was presented as done.
Two cautions. Only two of more than two dozen deals have been released, so these terms cannot be assumed to hold for the rest. And Public Citizen, which opposes the deals, is the source for several claims about the Lilly contract and for an estimate that one carve-out could cost Medicaid nearly $1.7 billion; that figure is the group's own and is conditional. No one has alleged that the contracts are illegal. Peter Maybarduk of Public Citizen said, “Trump's drug pricing deals are a mirage.”
The administration's answer: White House spokesman Kush Desai said the contracts contain “commercially sensitive information,” Pfizer called its deal “a win for American patients,” and the health department's deputy secretary nominee told senators the administration is not hiding anything. At that hearing Sen. Elizabeth Warren demanded, “Show me the receipts!” On September 18 Trump said of the pricing program, “This one thing alone should win us the midterms.” Kathy Hempstead of the Robert Wood Johnson Foundation told the Associated Press, “No one knows what is in these deals” (see Drug Prices Really Did Fall the Most Since 1963. Trump's Claim That Americans Now Pay 'the Lowest Price Anywhere in the World' Is Still False and Trump Launches TrumpRx.gov, a Government Prescription Drug Program Bearing His Name).