President Trump has made lowering prescription drug prices a clear priority, repeatedly arguing that Americans should not be forced to pay more for medicine than patients in other developed countries. Drugmakers have publicly welcomed that message. But their actions tell a more complicated story.
First reported by Reuters this week, pharmaceutical companies are raising list prices on more than 350 drugs for 2026. Many of the increases were small, but others were not, including sharp hikes on certain hospital-administered and specialty medicines that patients and providers rely on every day.
Among the steepest increases were those for Demerol, a painkiller used in obstetrics, whose price rose by 289 percent; Fragmin, an anti-blood clot treatment, whose price rose by 149 percent; Erythrocin, a branded antibiotic, which will cost 80 percent more in 2026; Cyclokapron, a hemophilia drug, which is priced 49 percent higher for 2026; and Epinephrine, which is used to treat life-threatening allergic reactions, and Marcaine, an anesthetic, whose prices increased by 22 percent each.
Oxycontin, the drug at the root of the opioid crisis which continues to be marketed by Purdue Pharma, will also get 9 percent more expensive– proving that a drug that wreaked carnage on much of the nation and especially regions like Appalachia, will continue to make its manufacturer wealthy.
Rising prices alone would be concerning enough. What makes the situation especially outrageous is what the industry is doing at the same time.
As prices rise, Big Pharma is ramping up its campaign against the 340B drug discount program, a no-cost-to-taxpayers system that allows safety-net hospitals and clinics to purchase outpatient drugs at reduced prices. Those savings are used to serve low-income and uninsured patients and to keep essential services running. The program disproportionately benefits rural, working-class Americans in states like Missouri, Arkansas, Louisiana, Kentucky, West Virginia and Tennessee.
The optics of trying to kill a drug discount program while simultaneously hiking prices well above the rate of inflation could prove to be an optics headache for the drug industry.
Drugmakers are also backing state and federal proposals to sharply restrict pharmacy benefit managers. Known as PBMs, those entities are typically insurers who negotiate discounts for patients, which ensures they do not pay the list price for drugs– which, as the 2026 numbers show, will be rising on average 4 percent this year but could rise by as much as 289 percent in the case of some medications.
Some of those proposals would prevent PBMs from earning more when they negotiate greater savings on behalf of insurers and employers–in other words, policies that punish cost reduction. By removing the profit motive for PBMs doing their job, negotiators could wind up closing up shop altogether, which would leave patients with no alternative but to pay high list prices set by Pharma companies.
None of this amounts to a public rejection of Trump’s agenda. Taken together, however, price hikes paired with efforts to dismantle cost-control mechanisms undermine the spirit of the restraint drugmakers claim to support. The situation also could complicate GOP efforts to hold the House, which Trump indicated this week was essential for avoiding a third impeachment by Democrats.
If the goal is truly to lower drug prices, it is fair to ask why the industry keeps targeting the few systems that actually help make that possible.
