Trump once again waved the flag of drug price reform, planning to promote a "international linkage" policy to challenge the pharmaceutical giants.

According to two informed sources close to the decision-making level, the US pharmaceutical industry recently received a warning from the White House: the Trump administration is considering restarting the "international reference pricing" plan, intending to link drug prices in the US with those in developed countries' markets. This move, considered the "most feared policy in the pharmaceutical industry," may be enforced through the Centers for Medicare and Medicaid Services (CMS), with its impact potentially far exceeding the previously threatened drug tariff policy. Analysts believe that compared to the still pending drug tariff scheme, directly introducing an international drug price reference system will completely overturn the pricing mechanism in the US pharmaceutical market. As the country with the highest drug prices globally (three times the average of developed countries), the US has long relied on maintaining high profits through a "market island." If drug prices are aligned with those in other countries, pharmaceutical companies' profit margins will face significant compression. It is worth noting that this is President Trump's second attempt to promote this policy. As early as during his presidency in 2020, the White House introduced a similar proposal, which was ultimately rejected by federal judges on grounds of "market intervention exceeding authority." Analysts point out that restarting this policy at this time is not only to fulfill election promises but also a strategy to shift the focus and relieve pressure on midterm elections. Regarding the implementation path of the policy, sources predict that reforms will be made to the Medicare reimbursement system through CMS, establishing reimbursement standards based on international drug prices. This means that even if pharmaceutical companies maintain high pricing strategies, the federal government will significantly reduce procurement prices, prompting a restructuring of the drug pricing system. Currently, pharmaceutical lobbying groups are urgently mobilizing to seek exemptions before the final plan is announced. If this policy is implemented, it will fundamentally change the global pharmaceutical industry landscape. Reference countries such as Europe and Japan may face pricing pressure from US pharmaceutical companies, while emerging pharmaceutical markets may see the introduction of "discounted dumping" by US companies. This drug pricing revolution driven by the White House is causing a chain reaction in the global pharmaceutical market.