President Donald Trump just added nine more drug companies to his Most-Favored-Nation (MFN) pricing push. That brings the total to 26 companies, covering 89 percent of the branded drug market.

The new agreements are with Alcon, Astellas Pharma, BeOne Medicines, BridgeBio, CSL, Kyowa Kirin, Sun Pharma, Teva Pharmaceuticals, and UCB. Each agreed to give state Medicaid programs access to prices tied to what the companies charge in other developed countries. 

Trump announced the deals from the Oval Office Monday.

"I'm thrilled to announce a major expansion of one of our signature affordability initiatives. Something that people have been trying to get for years, for decades... and that's most favored nation drug pricing."

The idea behind the program isn't complicated. Americans have been paying far more for many prescription drugs than patients overseas. U.S. patients currently pay nearly three times as much as patients in other developed countries for prescription medicines. Trump has been leaning on manufacturers to close that gap, and backing that pressure with the credible threat of 100 percent tariffs on imported pharmaceuticals under a Section 232 national security investigation. That's what got Pfizer to the table first, and it's what has kept the deals coming.

This latest batch covers medicines for Parkinson's disease, hemophilia, macular degeneration, glaucoma, liver disease, skin conditions, and several cancers. The companies also agreed that new medicines they bring to market will be priced under the same MFN framework. 

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Health and Human Services Secretary (HHS) Robert F. Kennedy Jr. put the size of the expansion this way:

"Today brings us to a total of 26 companies that have now made agreements with us. These agreements cover nine out of 10 drugs that are used by Americans."

There is another part of these deals that shouldn't get lost in the drug-price numbers. The nine companies also committed at least $19.6 billion in near-term U.S. manufacturing investment. Several will provide active pharmaceutical ingredients to the Strategic Active Pharmaceutical Ingredients Reserve.

UCB is contributing 163 tons of the seizure medication levetiracetam. Sun Pharma is providing more than 78 tons of two antibiotics. Teva is contributing metronidazole and amlodipine, while Astellas will supply tacrolimus, which is used to prevent organ rejection after transplants.

BeOne Medicines also confirmed its agreement Monday. The cancer-drug manufacturer said it will participate in the administration's Medicaid pricing program and price future FDA-approved drugs in line with other developed markets. The company has also announced another $300 million for its Hopewell, New Jersey, manufacturing and research operation, bringing its U.S. manufacturing investment above $1 billion.

Democrats have complained the agreements don't go far enough and that the individual terms aren't public. A July Health Affairs analysis supported the caveat about savings. The impact will vary by drug and coverage. But the same analysis called the deals "more than political theater" and a genuine shift in federal drug-pricing policy. That's a center-left journal, not the RNC.

Trump started this with Pfizer last September. Eleven months later, all 17 major manufacturers he originally targeted have deals; another nine companies have just joined them, and the administration says 89 percent of the branded market is now covered.

Washington has been promising to fix drug prices since the Clinton administration. Trump just got 26 companies to sign on the dotted line.