The news: The Trump White House announced most-favored-nation (MFN) agreements with nine midsize drugmakers, including Astellas, BeOne Medicines, CSL, Teva Pharmaceuticals, and UCB. The companies agreed to provide state Medicaid programs with MFN prices on their products and price new drugs in the US in line with the lowest available in other developed countries. They also committed to invest at least $19.6 billion collectively in US manufacturing.

The White House did not disclose tariff terms for all nine; BeOne secured an exemption, Kyowa Kirin a deferral, and Teva was still finalizing its agreement, per The Wall Street Journal.

As part of the deals, Astellas, Sun Pharma, Teva, and UCB also agreed to donate active pharmaceutical ingredients to the US Strategic Active Pharmaceutical Ingredients Reserve.

Why it matters: The agreements extend the framework that started with 17 large branded drugmakers, including Pfizer, AstraZeneca, and Eli Lilly, to midsize, specialty, and generic drugmakers. The latest round shows the administration extending MFN pricing commitments across companies with different portfolios and business models.

Those commitments may be more consequential for manufacturers that depend on a small number of products. Large drugmakers may be better able to offset lower pricing on one new treatment with revenue from a broader portfolio. For a midsize or specialty drugmaker, a single launch may represent a larger share of expected growth.

Implications for pharma companies: The expansion makes MFN pricing look less like a series of one-off agreements and and more like a near-term consideration for a wider range of drugmakers. With participating companies representing 89% of the branded drug market, according to the White House, international price comparisons will now factor into more US pricing decisions.

The overall effect will depend on how many drugs receive lower Medicaid prices, how many medicines launch under the agreements, and how long the terms remain in place. Still, the administration has secured pricing commitments without new legislation, expanding the role of global benchmarks in US drug pricing at least while the agreements remain in effect.

The latest deals also signal that the administration wants MFN commitments to cover as much of the pharma market as possible. Midsize, specialty, and generic drugmakers without deals may continue to face White House pressure to participate.

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