Billionaire hedge‑fund manager Bill Ackman is declaring an ideological victory after President Trump’s latest Truth Social post declaring his intent to slash drug pricing by massive margins. “President @realDonaldTrump must have liked my idea,” Ackman wrote Monday, reposting a March thread in which he urged the United States to ban pharmaceutical companies from charging lower prices overseas than at home.
Over the weekend, President Donald Trump used Truth Social to preview a new executive order he says will slash U.S. drug prices by “30 % to 80 %” by tying them to the cheapest price paid anywhere in the world under a “Most Favored Nation” (MFN) model — effectively the same outcome Ackman proposed. The President teased this post as “one of the most important and impactful… ever issued.”
What Trump’s Order Would Do
The executive order, signed Monday, calls for various actions, including:
- Instructs the Department of Health and Human Services to allow American consumers to buy pharmaceuticals directly from manufacturers at MFN prices.
- Orders the Secretary of HHS to impose MFN pricing on manufacturers that fail to offer such pricing.
- Empowers the Commerce Secretary to take action against foreign countries that undercut MFN pricing for the U.S. market.
The measure follows an April 15 executive order that re‑opened drug importation pathways, capped insulin costs in community health centers, and told regulators to accelerate generics and biosimilars.
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Ackman’s Angle
Ackman, chief of Pershing Square Capital Management, has long argued that Americans “subsidize drug development for the rest of the world.” His tweeted plan — making it illegal to sell cheaper abroad — would raise foreign prices while lowering U.S. prices, forcing a single global rate. Trump’s MFN approach reaches the same destination from the opposite direction: instead of lifting overseas prices first, Washington would leverage its buying power to pull U.S. prices down and dare firms to hike prices elsewhere.
The winners of this EO are expected to be Medicare beneficiaries, uninsured cash‑pay patients, and budget hawks. Trump claims “trillions” in savings for citizens in the U.S., with some unlikely allies even coming to support the policy.
Multinationals such as Pfizer, Merck, Amgen and high‑margin biotech firms that earn double‑digit shares of revenue from the U.S. market are expected to take a hit from the EO. However, many of these stocks were actually higher in Monday trading following an announcement of tariff relief from a provisional U.S.-China trade deal. Extended litigation will likely cap any immediate volatility among these names as well.
Ackman’s social‑media victory lap underscores a rare convergence between Wall Street activism and populist politics: both now target drug‑price disparities once dismissed as an intractable feature of the global patent system. Whether Trump’s executive pen can do what Congress and past presidents could not - force a trans‑national price reset - will hinge on the fine print, the courts, and the pharmaceutical industry’s appetite for a global game of chicken. For the moment, American patients and investors alike are bracing for historic change.
On the date of publication, Caleb Naysmith did not have (either directly or indirectly) positions in any of the securities mentioned in this article. All information and data in this article is solely for informational purposes. For more information please view the Barchart Disclosure Policy here.
