The gov­ern­ment has so far pre­vailed about a dozen times in le­gal chal­lenges against Medicare’s drug price ne­go­ti­a­tion pro­gram.

But the fight isn’t over.

Since March 2024, fed­er­al courts across at least four cir­cuits have re­ject­ed drug­mak­ers’ at­tempts to over­turn pro­vi­sions of the In­fla­tion Re­duc­tion Act be­fore new prices take ef­fect in Jan­u­ary 2026. But a hand­ful of cas­es are still un­de­cid­ed and, in the com­ing weeks, As­traZeneca is gear­ing up to po­ten­tial­ly ap­peal its case to the US Supreme Court.

The gov­ern­ment is “win­ning a lot of bat­tles, but the war is still go­ing on,” said An­drew Twina­mat­siko, di­rec­tor of the O’Neill In­sti­tute’s Cen­ter for Health Pol­i­cy and the Law at George­town Uni­ver­si­ty.

Eli Lil­ly on Thurs­day took a page from Pres­i­dent Don­ald Trump's play­book and will ask Eu­rope to pay more for phar­ma­ceu­ti­cals over the next sev­er­al weeks.

Call­ing the change a "re­bal­anc­ing," the In­di­anapo­lis drug­mak­er said Thurs­day that "prices for med­i­cines paid by gov­ern­ments and health sys­tems need to in­crease in oth­er de­vel­oped mar­kets like Eu­rope in or­der to make them low­er in the US."

Lil­ly said it ex­pect­ed the price changes to take ef­fect by Sept. 1, with­out say­ing what drugs would be af­fect­ed, how much prices would change, or in what mar­kets those changes would hap­pen.

The com­pa­ny did­n't an­nounce any new, low­er prices in the US — an­oth­er pri­or­i­ty of Trump's "most fa­vored na­tion" plan — but in­stead point­ed to struc­tur­al as­pects in the US health­care sys­tem, such as cost-shar­ing pro­grams by in­sur­ers and the 340B drug dis­count pro­gram run by hos­pi­tals.

HHS Sec­re­tary Robert F. Kennedy Jr. said he is "on­ly" end­ing gov­ern­ment fund­ing for mR­NA-based res­pi­ra­to­ry vac­cines, like those for Covid-19 and flu, but not for mR­NA-based on­col­o­gy vac­cines.

In an in­ter­view with Scripps News on Wednes­day, Kennedy said that can­cer vac­cines root­ed in mR­NA "may be very ef­fec­tive." The com­ments echo sim­i­lar ones made by NIH Di­rec­tor Jay Bhat­tacharya in the Wash­ing­ton Post on Tues­day, where he called mR­NA vac­cines for can­cer "promis­ing."

Both Bhat­tacharya and Kennedy sought to de­fend HH­S' de­ci­sion ear­li­er this month to can­cel or re­work about two dozen BAR­DA con­tracts worth about $500 mil­lion for the de­vel­op­ment of mR­NA vac­cines, in­clud­ing for flu and Covid. Part of the ra­tio­nale, ac­cord­ing to Kennedy, is that the gov­ern­ment wants to fund vac­cines "that tar­get not just a sin­gle anti­gen but the en­tire virus," and that pro­vide ster­il­iz­ing im­mu­ni­ty "for all strains of the virus."

Pres­i­dent Don­ald Trump signed an ex­ec­u­tive or­der on Wednes­day call­ing for health of­fi­cials to build a six-month stock­pile of ac­tive phar­ma­ceu­ti­cal in­gre­di­ents for "crit­i­cal" drugs in the US.

The Of­fice of the As­sis­tant Sec­re­tary for Pre­pared­ness and Re­sponse (AS­PR) with­in HHS has 30 days to com­pile a list of the ap­prox­i­mate­ly 26 drugs, ac­cord­ing to the ex­ec­u­tive or­der.

The or­der comes as the bio­phar­ma in­dus­try awaits de­tails sur­round­ing in­dus­try-spe­cif­ic tar­iffs, fol­low­ing the De­part­ment of Com­merce’s Sec­tion 232 in­ves­ti­ga­tion which start­ed in April.

There are al­so grow­ing con­cerns that drug­mak­ers could turn to cheap­er sources, like Chi­na, for raw ma­te­ri­als to ease the im­pact of US tar­iffs. This week, Ab­b­Vie de­tailed its plan to build an API fac­to­ry in the US.