Despite campaign promises to lower prescription drug prices on day one, Americans are paying more for their medications in 2025 than ever before. When President Trump took office in January 2025, pharmaceutical companies did the opposite of what was promised—they announced price increases on more than 250 branded drugs within the first few days of the year. The gap between political promise and pharmaceutical reality could not be more stark. A diabetic patient who relies on Ozempic for glucose management faced a 3% price increase right at the start of the year. Someone managing atrial fibrillation with Eliquis saw a 2% jump.
These aren’t hypothetical scenarios—they’re the lived reality for millions of Americans who woke up to expensive medication bills while hearing about executive orders meant to bring prices down. The numbers tell a brutal story. Across 590 branded drugs tracked in January 2025, the median price increase hit 4.5%, affecting 575 different medications. Only seven drugs saw price decreases. This wasn’t a gradual drift—it was a coordinated surge that happened immediately upon the new administration taking office, creating a stark contradiction between stated intention and actual market behavior. The executive order signed on May 12, 2025, titled “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” promised relief that never materialized for the patients who needed it most.
Table of Contents
- Why Didn’t the Price-Lowering Promise Work?
- The Scope of Price Increases Across Common Medications
- Real Examples of Prescription Price Increases in 2025
- How Price Increases Affect Out-of-Pocket Costs for Patients
- The Limits of Executive Action on Drug Pricing
- Systemic Issues Beyond Executive Orders
- Looking Forward: What Changes Might Actually Work
- Conclusion
Why Didn’t the Price-Lowering Promise Work?
Understanding why drug prices kept climbing despite executive action requires looking at how pharmaceutical pricing actually works. The executive order relied on mechanisms like reference pricing and international price benchmarking, but these strategies take months or years to implement and have numerous legal and logistical hurdles. Pharmaceutical companies, knowing these delays would occur, moved quickly to raise prices under the old system before new rules took effect. They essentially priced in their expected losses from future regulation by jacking up prices now.
The pharmaceutical industry has long used a strategy of front-loading price increases before anticipated regulation. They had months of warning about the incoming administration’s intentions, which gave them time to plan their January price hikes. This created a perverse incentive structure: the stronger the political commitment to lower prices, the faster companies rush to increase them first. Patients caught in this timeline pay the price—literally—for the lag between policy announcement and policy implementation.
The Scope of Price Increases Across Common Medications
The January 2025 price increases weren’t limited to niche or specialty drugs—they hit some of the most commonly prescribed medications in America. Biktarvy, an HIV treatment made by Gilead, saw a 5.9% increase. Hemlibra, a hemophilia treatment from Genentech, jumped 8%. Abilify Maintena, used to treat bipolar disorder and schizophrenia, went up 3%. These are drugs that millions of Americans depend on daily just to function, not luxury items or last-resort treatments.
The median increase of 4.5% might sound modest until you realize it compounds year after year—and that’s just what happened in these first two days of 2025. What makes this particularly concerning is the context of long-term price escalation. The 25 most commonly used drugs in Medicare have nearly doubled in price since they first entered the market, with an average increase of 98% over approximately 11 years. That means a patient who started taking one of these drugs a decade ago has likely seen their out-of-pocket costs multiply. Adding another 4.5% increase on top of that decade-long price spiral pushes many people to impossible choices—skip doses, reduce dosage, or go without entirely. Insurance companies often respond to price increases by raising copayments, shifting more cost directly to patients.
Real Examples of Prescription Price Increases in 2025
Looking at specific drugs tells the human story behind the statistics. Ozempic, the popular diabetes and weight-loss medication, increased 3% in January 2025. For someone paying $500 per month out of pocket, that’s $15 more monthly—or $180 annually—added to their healthcare budget without warning or justification. Multiply that by the millions of Americans prescribed Ozempic, and you’re looking at hundreds of millions in additional patient burden. Jardiance, another common diabetes medication, also jumped 3% at the same time, offering patients no alternative that didn’t involve similar increases. Eliquis presents a particularly important case study.
This blood thinner prevents strokes in people with atrial fibrillation, a condition that affects millions. Its 2% increase might seem small until you consider that most patients have no alternative—other anticoagulants have different side effect profiles, and switching requires doctor approval and new prescriptions. Patients on these medications aren’t shopping around looking for deals. They’re taking what their doctor prescribed because their health depends on it. Pharmaceutical companies know this, and it’s part of why they can raise prices with such confidence. There’s one notable exception: Januvia and Janumet, diabetes drugs made by MSD, actually saw a 42% price cut. This rare instance of price reduction only highlights how unusual such cuts are and raises questions about why similar reductions aren’t happening across the industry.
How Price Increases Affect Out-of-Pocket Costs for Patients
The sticker price of a medication isn’t always what patients pay, but higher list prices inevitably filter down to higher patient costs. Insurance companies structure copayments as percentages of list price or set copayment tiers based on how expensive a drug is. When Hemlibra’s price jumps 8%, that affects not just what insurance companies pay but what hemophilia patients pay when they pick up their prescription. For someone on a fixed income or already struggling with medical bills, a seemingly small percentage increase can be the difference between affording medication and going without.
Many Americans don’t have comprehensive insurance or have high-deductible plans where they’re responsible for the full price until reaching their deductible. For these patients, a $15 increase on Ozempic is immediate and direct—it comes out of their pocket that month. Others face copayment increases as insurance companies adjust their benefit designs in response to higher drug prices. The cumulative effect across multiple medications—many people take three, four, or even more daily—can become overwhelming. Someone managing diabetes with Ozempic while also taking Eliquis for heart health and Abilify for depression now faces increased costs on all three medications simultaneously.
The Limits of Executive Action on Drug Pricing
Executive orders are powerful tools, but they have real limits when it comes to controlling pharmaceutical prices. The executive order signed in May 2025 relies on mechanisms that require regulatory approval, congressional coordination, and time to implement. Most importantly, these mechanisms can face legal challenges from pharmaceutical companies that have spent billions building patent protections and market positions. What works in policy documents often encounters resistance in courtrooms and in the complex regulatory machinery that governs drug approval and pricing. The pharmaceutical industry also has numerous legal and regulatory tools to defend high prices.
They can argue that lower prices will reduce research funding, slow innovation, or hurt patient access to future treatments. Some of these arguments have merit—drug development is genuinely expensive. But the argument has also become a standard defense tool used to prevent any meaningful price reduction, regardless of the actual research pipeline or profit margins. The timing of the January 2025 increases—happening right when everyone was paying attention to the new administration’s promises—suggests the industry was confident these price hikes would stick despite regulatory intentions. History suggests they were right to be confident.
Systemic Issues Beyond Executive Orders
The drug pricing problem runs deeper than any single policy initiative. Americans have no mechanism to collectively negotiate drug prices, unlike nearly every other developed nation. Medicare, despite covering millions of seniors, was historically prohibited from negotiating drug prices directly. Recent legislation changed this somewhat, but implementation remains slow and limited.
Meanwhile, pharmacy benefit managers—the middlemen who negotiate between insurance companies and drugmakers—operate with less transparency than anyone involved in the system would prefer, and their incentive structures don’t always align with patient interests. The lack of price transparency also compounds the problem. A patient might have no idea whether their medication is cheaper at one pharmacy versus another, or what the actual cost is versus what their insurance pays. This information asymmetry favors pharmaceutical companies and allows them to maintain high prices across the board. When the January 2025 price increases happened, most patients had no way to predict them or prepare for them.
Looking Forward: What Changes Might Actually Work
The gap between the promise and the reality of January 2025 raises an important question: what would it actually take to lower drug prices? International price benchmarking could work, but only if the reference prices are set aggressively and companies face real consequences for exceeding them. Allowing Medicare to negotiate prices more broadly could help, though the pharmaceutical industry has successfully limited this so far. Shortening patent protections or limiting exclusivity periods might spur generic alternatives faster. None of these solutions are quick, and all face resistance from an industry that has successfully shaped drug policy for decades.
What’s clear from early 2025 is that announcements and executive orders aren’t sufficient. The companies that raised prices on 250+ drugs in January did so confidently, suggesting they believe they’ll be able to maintain these prices despite regulatory efforts. Whether those assumptions hold will depend on whether policy makers follow through with actual enforcement mechanisms and are willing to take on the pharmaceutical industry’s legal challenges. For now, patients face the reality: despite promises to lower drug prices on day one, the prices on the most common prescriptions all went up.
Conclusion
The January 2025 price increases on more than 250 branded drugs represent a fundamental disconnect between political promises and pharmaceutical market reality. Patients with diabetes, heart disease, mental illness, and blood disorders saw their medication costs increase within days of a new administration taking office with explicit promises to lower drug prices. From Ozempic to Eliquis to Biktarvy, the most commonly prescribed medications all became more expensive, not less. This wasn’t an accident or an unforeseen market development—it appears to be a deliberate strategy by pharmaceutical companies to raise prices before new regulatory mechanisms could take effect.
Moving forward, patients and policymakers should recognize that drug pricing requires sustained, concrete action, not just policy announcements. This means accepting that prices might continue to rise until real enforcement mechanisms are in place. If you’re struggling to afford your medications, explore patient assistance programs offered by manufacturers, ask your doctor about generic alternatives, and consider talking to a pharmacist about cost-saving strategies. At the broader level, the lesson from early 2025 is clear: the pharmaceutical industry moves faster than government, and patients are caught in the middle.