Drug Price Hikes Hit 350 Medicines Despite Trump Pricing Deals

The January ritual continued

The drug industry's yearly round of January price increases went ahead in 2026, even after months of White House announcements about deals with drugmakers. Reuters published an exclusive on New Year's Eve, using data from healthcare research firm 3 Axis Advisors. It reported that manufacturers planned to raise U.S. list prices on at least 350 branded medicines, including COVID, RSV and shingles vaccines and Pfizer's widely used breast cancer drug Ibrance.13 At the same point a year earlier, the count was a little over 250. The median increase stayed at about 4%, the same as in 2025.15 These are list-price changes only. They do not include rebates paid to pharmacy benefit managers or other discounts.1

The 350 figure was only a starting point. By mid-January, drug-pricing nonprofit 46brooklyn had counted 872 brand-name products with list-price increases and just 18 with cuts.4 Its full review of the month found 951 increases and 20 decreases. That made January 2026 the third-highest January for net increases in its dashboard, close to January 2025.8 The early Reuters number was an advance look at a familiar pattern, not a sign of something new.

Deal signers raised prices too

The politics of the story come from who raised prices. Trump had reached agreements with 14 drugmakers covering some of their medicines for Medicaid and for cash-paying patients. Pfizer, Sanofi, Boehringer Ingelheim, Novartis and GSK were among those deal signers that also scheduled January 1 increases.15 By mid-January the number of companies with deals had grown to 16. NPR reported that every one of them had raised list prices on at least some products.5

Pfizer, the first company to sign a deal with the White House, had the most increases. Reuters counted about 80 drugs, including Ibrance, the migraine pill Nurtec, the COVID antiviral Paxlovid, and hospital drugs such as morphine and hydromorphone.1 Most of Pfizer's increases were under 10%. Its COVID vaccine Comirnaty went up 15%, and some cheaper hospital products more than quadrupled in price.15 46brooklyn counted 72 Pfizer products. That gap probably reflects differences in timing and in how products are counted, not a real disagreement.5 GSK planned increases of 2% to 8.9% on about 20 drugs and vaccines.1 Merck raised prices on 18 products, including the HIV drug Isentress.5

Pfizer's defense was the industry's usual one. It said the average list-price increase across its innovative medicines and vaccines was below inflation, and that the money funds research and covers rising costs.1 Pfizer also told NPR that its net prices, meaning what insurers pay after discounts, have been falling.5 Asked whether the increases broke the deals, a White House spokesperson said list prices are not important. He said the discounts in the deals go to state Medicaid programs and cash-paying patients.5

Weight-loss drugs: cheaper in one channel, pricier in another

GLP-1 drugs show the split most clearly. In November 2025, Lilly and Novo Nordisk agreed to most-favored-nation pricing on semaglutide and tirzepatide. Medicare would pay $245 a month for the injectables, Medicare would cover Wegovy and Zepbound for some obese patients, and cash buyers would get lower prices through TrumpRx.26 When TrumpRx.gov launched in February, the White House listed injectable Wegovy and Ozempic from $199, the Wegovy pill from $149, and Zepbound from $299, depending on dose.23

List prices moved the other way that same January. Novo Nordisk and Lilly each raised the list prices of Ozempic and Mounjaro by 3%.2 46brooklyn ranked Ozempic's 3% increase among the month's most consequential because of how much Medicaid spends on the drug.8

The cash-price story is also less dramatic than the White House comparisons suggest. TrumpRx compares its prices to U.S. list prices, but Novo already sold the Wegovy pill for $149 a month on its own direct-to-consumer site. Patients who order Zepbound vials through TrumpRx are sent to LillyDirect.24 Later reporting found that some low TrumpRx prices were introductory. Wegovy's $199 price reportedly rose to $349 after two months.22 Before the deal, the companies were already charging about $499 a month through their own cash channels. That makes a more realistic discount roughly 30%, not the 70%-plus implied by comparing with list prices.26

These changes do matter to the people they reach. The GLP-1 discounts are targeted, though. They lower prices for cash buyers and government programs and leave the list price, which drives many insured patients' costs, slightly higher.

Cancer drugs and the Medicare exception

Cancer treatment shows the same split. Ibrance went up as part of Pfizer's increases.13 The few large cuts came mainly from a different policy: Medicare drug price negotiation under the Inflation Reduction Act. The first ten negotiated Medicare prices took effect in January 2026, with discounts of 38% to 79%. The leukemia drug Imbruvica had the smallest discount at 38%.7 Imbruvica's commercial list price fell 41.5% in December 2025. Jardiance and Farxiga also took large list-price cuts in January.4 Reuters reported that Boehringer cut Jardiance's list price by more than 40%. 46brooklyn later put the cut at 44.4%.18

The negotiation program did not carry over to commercial prices across the board. 46brooklyn found that four of the ten negotiated drugs had big list-price drops, four were unchanged and two went up.5 Stelara and Enbrel rose 5% even though their Medicare prices were negotiated down.4

The main policy lesson here is clear. The largest list-price cuts of the season came from a law with enforcement attached, not from voluntary agreements. Drug Discovery Trends noted that Boehringer's Jardiance cut was driven by the negotiation requirements, not by its most-favored-nation deal, and that its other products still went up.7

Does the list price matter?

The sharpest disagreement in the coverage is over whether list prices are the right measure. Drug Channels argues that net prices for brand-name drugs fell in 2025 even as list prices rose about 3.5%. It also criticizes Reuters for focusing on list-price increases.9 46brooklyn found something that partly supports that view. Weighted by Medicaid utilization, January's brand price changes came out to a net decrease of 0.6%. A small number of large cuts on heavily used drugs outweighed hundreds of increases, which it said had never happened in its tracking.8 USA Today reported a similar result: 46brooklyn's Medicaid analysis showed prices falling slightly in 2026.2

Those findings matter, but they do not settle the question. Medicaid and Medicare have penalties that limit price increases above inflation. Commercial employers and cash-paying patients may have no such protection.8 Experts told Healthline that higher list prices often mean higher out-of-pocket costs for people with high-deductible plans or no insurance, even when insurers get discounts.11 There is also a ratchet effect. Annual percentage increases are smaller than a decade ago, but median launch prices for new drugs are approaching $400,000 a year, so a 4% increase on that base is a lot of money.2

The White House is right that list prices are not what most insured Americans pay, and the net-price data support that. But list prices still set copays, coinsurance and deductible exposure for a large share of patients. For them, a 4% increase means a higher pharmacy bill.

The bottom line

The January data tell a consistent story. The administration's voluntary deals produced real but narrow concessions: cheaper GLP-1s for cash buyers and lower prices for Medicaid. They did not change how manufacturers set list prices across their product lines. Brigham and Women's researcher Benjamin Rome told Reuters the deals only "nibble around the margins" of what drives high U.S. drug prices.15 Healthline quoted an Auburn University public health historian who said political pressure alone is unlikely to change those incentives without broader price-control authority.11

The White House's answer was to ask Congress to make the most-favored-nation savings law.23 That is effectively an admission that voluntary agreements have limits. The 2026 price season showed that the meaningful price cuts came where there was enforceable law, mainly Medicare negotiation, and that elsewhere the 4% median list-price increase continued as usual.