Health and social policy

Executive Order 14273: Lowering Drug Prices by Once Again Putting Americans First

President: Donald J. Trump

Directed HHS and other agencies to pursue Medicare negotiation improvements, 340B access, importation, price transparency, PBM action and competition measures.

Status: In effect. Is Executive Order 14273 still in effect? Yes. Executive Order 14273 remains in effect. See Federal Register record.

Medicine containers, a downward arrow, coins and a balance appear beside a policy document and U.S. map.
Drug-pricing policy, illustrated symbolically; the downward arrow is not evidence of achieved price reductions or a particular patient’s savings. EO Explained · site-generated editorial illustration · not documentary evidence.

What does Executive Order 14273 do?

HHS, FDA and the trade commission were assigned separate pricing, importation and competition reviews under existing law.

Administration position: The order’s evaluative language and policy rationale are administration positions. This guide distinguishes them from official acts, reports and judgments.

Reading the operative provisions of Executive Order 14273

EO 14273 directs HHS and other agencies to pursue several approaches to prescription-drug affordability, including Medicare negotiation, 340B program access, importation, price transparency, pharmacy benefit manager practices and competition. These provisions are instructions to agencies to review or develop actions under existing law. The order does not set one national price for each prescription or automatically change a patient’s coverage. Its text appears in the Federal Register publication of EO 14273.

The topics involve separate statutory programs. Medicare drug-price negotiation is governed by the Inflation Reduction Act and CMS procedures; 340B requires covered entities and manufacturers to follow a distinct federal program; drug importation depends on FDA safety requirements; and pharmacy benefit manager practices may implicate several agencies and state laws. An instruction to review these areas does not suspend an existing statute or program while agencies consider policy options.

Each later action must be evaluated on its own record. A proposed rule can be changed after public comment; a guidance document may explain an agency view without having the same effect as a legislative rule; a negotiated Medicare price applies to specified drugs and program years. Patients should check current CMS, FDA and plan information for the product and coverage at issue. To measure the order’s policy effect, distinguish agency studies and deadlines from final rules, approved importation plans, negotiated prices and enforcement outcomes.

SignedApril 15, 2025
Lead officialsHHS, CMS, FDA, FTC and Commerce
Express timing30-, 60-, 90- and 180-day actions

Before and after

Before the order

Drug pricing was governed by Medicare, Medicaid, 340B, FDA and competition statutes and existing programs.

After the order

CMS revised negotiation guidance, HHS advanced real-time price information and 340B insulin and epinephrine access, and later actions created additional pricing programs.

Who had to do what

Agency / officeActionTiming / position
HHS/CMSImplement Medicare and program pricing actions30 to 180 days
FDAStreamline importation and generics workOngoing
FTCAddress competition and PBM practicesOngoing

What happened next

EO 14273 signed.

CMS issued draft guidance for the 2028 negotiation cycle.

HHS announced real-time prescription price requirements.