President Donald Trump escalated pressure on pharmaceutical companies, issuing letters demanding alignment of U.S. drug prices with international benchmarks within 60 days, invoking a 'most favored nation' pricing policy. The administration seeks expanded Medicaid and Medicare drug access at lower prices, increased direct-to-consumer sales, and repatriation of foreign profits. Industry leaders including AstraZeneca and GSK express cautious adaptation, citing supply chain shifts and investments to mitigate tariff impacts. The sector faces complex regulatory and economic challenges amid ongoing pricing reforms.