U.S. President Donald Trump announced Sunday that he will sign an executive order aimed at slashing prescription drug prices by pegging them to the lowest rates paid by other wealthy nations—a move he framed as long-overdue economic justice for American consumers.

Posting on Truth Social, Trump said the order, set to be signed Monday morning, would introduce a “most favoured nation” pricing policy. This strategy—commonly known as international reference pricing—would ensure the U.S. pays no more than the lowest price any high-income country pays for the same medication.

“The United States will pay the same price as the Nation that pays the lowest price anywhere in the World,” Trump wrote. “They will rise throughout the World in order to equalize and, for the first time in many years, bring FAIRNESS TO AMERICA!”

The U.S. currently pays the highest drug prices globally, often two to three times what other developed countries pay for identical medications. While Trump has repeatedly criticised this disparity, he offered no detailed timeline or implementation plan for the policy.

Sources familiar with the matter say the order will likely apply to drugs purchased through Medicare and may extend beyond the limited list already selected for negotiation under former President Joe Biden’s Inflation Reduction Act. That law enabled Medicare to begin negotiating prices for 10 high-cost drugs, with the first negotiated rates set to take effect in 2026.

The pharmaceutical industry quickly pushed back. Alex Schriver, spokesperson for the Pharmaceutical Research and Manufacturers of America (PhRMA), said: “Government price setting in any form is bad for American patients.”

This is not Trump’s first attempt to tie drug prices to international benchmarks. A similar effort during his first term was blocked in federal court. At the time, his administration claimed the plan could save over $85 billion over seven years, targeting a portion of the U.S.’s more than $400 billion annual drug expenditure.

The new order signals a renewed push by Trump to deliver on a key campaign promise—bringing down drug prices—while sharpening contrasts with the pharmaceutical industry ahead of the 2026 midterms.