When the Trump administration signed the Section 232 pharmaceutical tariff proclamation on April 2, 2026, it didn't catch everyone off guard. Behind the scenes, the White House had spent weeks negotiating bilateral deals with the largest pharmaceutical companies in the world. The result: 13 companies locked in 0% tariff rates before the ink was dry.
These are the Annex III companies — named after the third annex to the presidential proclamation — and understanding their deals is critical for any patient trying to figure out what their prescriptions will actually cost in late 2026.
The 13 Annex III Companies
The following pharmaceutical manufacturers have signed Most Favored Nation (MFN) agreements with the US Department of Health and Human Services:
- AbbVie — Humira, Skyrizi, Rinvoq, Imbruvica
- Amgen — Enbrel, Prolia, Xgeva, Otezla, Repatha
- AstraZeneca — Farxiga, Tagrisso, Lynparza, Imfinzi
- Bristol Myers Squibb — Opdivo, Revlimid, Eliquis (with Pfizer), Orencia
- Boehringer Ingelheim — Jardiance (with Lilly), Ofev, Spiriva
- Eli Lilly — Mounjaro, Zepbound, Trulicity, Jardiance, Verzenio
- EMD Serono — Rebif, Bavencio, Erbitux
- Genentech (Roche) — Herceptin, Avastin, Tecentriq, Ocrevus, Perjeta
- Gilead Sciences — Biktarvy, Descovy, Veklury, Trodelvy
- Merck — Keytruda, Januvia, Gardasil, Winrevair
- Novartis — Cosentyx, Entresto, Kisqali, Lutathera
- Novo Nordisk — Ozempic, Wegovy, Victoza, Tresiba, NovoLog
- Sanofi — Dupixent, Lantus, Toujeo, Praluent
What an MFN Deal Actually Requires
An MFN deal is not a simple tariff exemption — it comes with strings attached. Each company must:
1. Offer Americans their lowest global drug prices — if Novo Nordisk sells Ozempic cheaper in Germany than in the US, they must match that price for American patients under the deal terms.
2. Commit to domestic manufacturing investment — a defined dollar amount or production milestone in US-based pharmaceutical manufacturing.
3. Accept an effective date of July 31, 2026 — earlier than the September 29 date for non-deal companies.
In exchange, all drugs from these companies pay 0% under the tariff. The deals are set to expire January 20, 2029 unless renewed.
What About Drugs From These Companies That Aren't Listed?
The MFN deal covers the manufacturer, not specific drugs. If a company is on the Annex III list, all of their patented brand-name drugs qualify for the 0% rate — not just their flagship products. So even lesser-known drugs from AbbVie or Merck fall under the deal umbrella.
However, it's worth noting: the deal covers only drugs that the company *manufactures*. Drugs licensed to another company for manufacturing could have a different classification. Use our drug search tool to verify any specific medication.
Which Major Companies Are NOT in the Deal?
Notably absent from the Annex III list are several major pharmaceutical players:
- Pfizer — Despite co-marketing Eliquis with BMS (which has a deal), Pfizer itself is not on the list
- Johnson & Johnson — Tremfya, Stelara, Darzalex are potentially at the 100% rate
- Bayer — Xarelto, Eylea
- Takeda — Vyvanse, Entyvio
- UCB — Cimzia, Vimpat
Drugs from these companies — unless manufactured in an exempt country or covered by another exemption — face the default 100% tariff as of September 29, 2026.
What This Means for Patients
If your drug is from one of the 13 Annex III companies: you are protected. Your drug pays 0% tariff under the MFN deal. You may also benefit from the MFN pricing commitment, which could actually *lower* your drug's cost over time.
If your drug is from a company not on the list: check whether a generic exists (fully exempt at 0%), whether your drug is in a specialty exempt category, and whether the manufacturer is based in the EU, Japan, Korea, Switzerland, or UK (which get 10–15% rates rather than 100%).
Use the RxTariff drug search tool to instantly check your specific medication's current classification.