Gallego demands transparency in Trump's deal with Pfizer

Sen. Ruben Gallego (D-Ariz.) is raising concerns over the lack of details given about President Trump's "most favored nation" (MFN) pricing deal he announced with Pfizer this week, calling on the company's CEO to explain how it plans to execute the agreement.

In a letter to Pfizer CEO Albert Bourla, provided to The Hill, Gallego asked for clarity in his agreement with the Trump administration.

Bourla announced Tuesday at the White House that his company would be complying with all four of Trump's demands written out in his MFN executive order, signed in May.

The order called on manufacturers to provide preferential pricing to all Medicaid patients, required they not give better prices to other developed countries for new drugs, create direct-to-consumer sale platforms and use trade policy to raise prices internationally so that revenue is reinvested into lowering American prices.

"To date, few details about this deal have been made public. While the White House touted the agreement as a win for patients, neither the Administration nor Pfizer has disclosed which drugs are covered, what prices have been agreed to, or how patients will benefit," Gallego wrote.

"A press release from Pfizer stated that the 'specific terms of the agreement remain confidential,' which raises serious concerns about this arrangement," he added.

The senator asked what data would be used to make Pfizer's MFN formula, such as what countries will be referenced to set the price. He further asked whether Pfizer would be transparent in its pricing calculations.

Gallego asked how often the prices would be updated and how many drugs covered by Medicaid would subject to MFN pricing.

Chris Klomp, director of Medicare, said Tuesday that Pfizer would be making "virtually all of its portfolio of drugs" available to Medicaid at MFN pricing "in the near future."

Gallego speculated on whether Pfizer would shift costs onto other markets, such as from private insurers and employee-sponsored plans, asking whether MFN pricing would be expanded to commercial insurance and Medicare Part D markets.

"In addition to the MFN arrangement, I request clarification on Pfizer’s participation in the TrumpRx platform," Gallego wrote.

"As currently described, this model would require patients to bypass their insurance and pay cash for medications — often at high out-of-pocket costs. Given that many insured patients already have lower copays or coinsurance than the proposed TrumpRx discounts, it is unclear how this platform would provide meaningful relief. In fact, it may increase costs for patients."

Senior administration officials did not say whether insurance could be used on TrumpRx.com, which is expected to launch some time early next year.

Bourla on Tuesday indicated that Pfizer had received protections from tariffs as part of its deal with the White House, saying Trump had "graciously" given the company a "three-year grace period" from 232 tariffs.

Trump had threatened 100 percent tariffs on drugmakers that aren't building facilities in the U.S. beginning on Oct. 1, though the administration backed off to give negotiations more time.

"We have clarity about what is the framework for the U.S. price. Read the letter of President Trump, read the four points, and this is the framework, and we will abide by that. And going forward, this is how things will be priced in the U.S. and abroad," Bourla said, adding that his company was prepared to invest $70 billion over the next few years into manufacturing and research in the U.S.

The Hill has reached out to Pfizer for comment on Gallego's letter.