Hickenlooper, Bennet, Democratic Colleagues Demand Answers from Trump Admin and Drug Companies as Health Care Costs Skyrocket

Letter comes as 15 million Americans - and 241,000 Coloradans - brace to lose health care under cuts in Trump's tax and spending bill

WASHINGTON - U.S. Senators John Hickenlooper and Michael Bennet recently joined six of their Democratic Senate colleagues to demand four major pharmaceutical companies provide specific details about agreements they announced with President Trump to lower drug costs as millions of Americans see the cost of health care skyrocket.

On September 30, the Trump administration announced new agreements with drug manufacturers to lower the cost of prescription drugs. Now, as millions of Americans brace for their health care premiums to double, the Trump administration and drug manufacturers have provided few details about how and when Americans will see lower drug costs.

"The deep Medicaid cuts in H.R. 1 have put states in the impossible position of trying to figure out how to keep our Medicaid programs afloat and ensure continued patient access across the health care system writ large," the senators wrote.

"Critical details about the GENEROUS model also remain unclear, including whether manufacturers can seek exemptions for the drugs where this model could potentially have the greatest impact. It is difficult to draw any firm conclusions about what pricing manufacturers will have to offer states under the model and on which drugs," they continued.

The letters, sent to Pfizer, AstraZeneca, Novo Nordisk, and Eli Lilly ask for specific pricing information on which drugs will be affected by the announcements, what the "most favored nation" price is for those drugs, and what state Medicaid programs will pay in the wake of these announcements.

Hickenlooper and Bennet have been vocal opponents of the Trump administration's massive cuts to health care. Earlier this year, Republicans passed President Trump's so-called One Big Beautiful Bill Act which slashes over $1 trillion from Medicaid and the Affordable Care Act. Last week, Senate Democrats put forward a proposal to extend the Affordable Care Act enhanced premium tax credits for three years to save more than 24 million Americans from paying double for their health costs or losing their insurance entirely. In total, Republican cuts are expected to force 15 million Americans off their health insurance.

Last month, Hickenlooper and Bennet voted NO on the Republicans' government funding bill after Trump and MAGA Republicans shut down the federal government instead of addressing the health care crisis they created.

Full text of the letter to Pfizer is available HERE and below. Click HERE for the letter to AstraZeneca, HERE for the letter to Novo Nordisk, and HERE for the letter to Eli Lilly.

Dear Dr. Bourla:

On July 4, 2025, President Trump signed the Republican reconciliation bill (H.R. 1) into law. That bill included nearly $900 billion in cuts to the Medicaid program, which will create disastrous consequences for state budgets, and, in turn, access to health care services for Americans all across the country. States have few options when it comes to filling the hole left by massive federal cuts - all of which lead to less access for patients. States can either cut provider rates, cut services, or cut eligibility for Medicaid - each of these options will make Americans sicker, force hospitals to close and cut services, and increase health care costs for all.

The deep Medicaid cuts in H.R. 1 have put states in the impossible position of trying to figure out how to keep our Medicaid programs afloat and ensure continued patient access across the health care system writ large. With that in mind, we write today to seek more information from Pfizer about which drugs are subject to the Medicaid components of your agreement with the Trump administration and whether the prices you will make available on these drugs are actually lower than the net pricing states currently receive on the same products in Medicaid.

On September 30, 2025, you held a press conference with President Trump announcing that Pfizer would offer "most-favored nation" pricing on certain prescription drugs in Medicaid. It is clear that Pfizer stands to gain a lot from this agreement, including relief from tariffs and potential priority review of new drug applications at the Food and Drug Administration (FDA). The Trump administration is also pressuring other countries, such as the U.K., to pay higher prices for drugs, which will further increase revenues for industry, even though it is unclear whether industry will be expected to proportionally lower pricing in the U.S.

It is difficult to discern, however, what patients in Medicaid and taxpayers stand to gain from your agreement with the Trump administration. On November 6, 2025, CMS announced the Generating Cost Reductions for U.S. Medicaid Model (GENEROUS) model and released a corresponding request for applications from manufacturers. The GENEROUS model is a voluntary demonstration program under which CMS will negotiate supplemental rebates and coverage terms on prescription drugs with participating manufacturers. The Trump administration claims that these rebates will bring Medicaid drug costs closer to international pricing on covered outpatient drugs for states that choose to participate in the model. Presumably, manufacturers like Pfizer that have announced agreements with the Trump administration will be able to effectuate the Medicaid components of those agreements through the GENEROUS model.

States won't benefit if GENEROUS model prices are essentially the same as current Medicaid net prices or higher. Medicaid already pays the lowest drug prices in the U.S., often in line with the prices paid in other wealthy countries. For example, a 2021 analysis by the Congressional Budget Office (CBO) found that the average net price of top-selling brand drugs in Medicaid was $118, relative to an average price of $343 in Medicare Part D.1Critical details about the GENEROUS model also remain unclear, including whether manufacturers can seek exemptions for the drugs where this model could potentially have the greatest impact. Furthermore, the RFA explicitly states that terms under CMS agreements with manufacturers can differ from the terms CMS just publicly released about the model. Thus, it is difficult to draw any firm conclusions about what pricing manufacturers will have to offer states under the model and on which drugs.

Attached to this letter, you will find a table listing brand drugs currently marketed by Pfizer and a list of Pfizer subsidiary and affiliate companies. We ask that Pfizer promptly respond by populating those tables and providing the following information:

1. Does Pfizer plan to effectuate the Medicaid components of its drug pricing agreement with the Trump administration through the GENEROUS model? If not, please explain how Pfizer will effectuate its Medicaid drug pricing agreement with the Trump administration.

2. During which calendar years does Pfizer plan to either participate in the GENEROUS model or otherwise offer agreed upon pricing to state Medicaid programs pursuant to your agreement with the Trump administration?

3. Please populate Table 1 by:

a. Identifying which drugs in your current book of business are subject to the Medicaid part of your agreement with the Trump administration and/or will be included in the GENEROUS model;

b. Providing the second lowest country specific average net price on each drug identified above over the last 12 months from the following countries: the United Kingdom, France, Germany, Italy, Canada, Japan, Denmark, and Switzerland;

c. Providing the net price available to state Medicaid programs under your agreement with the Trump administration and/or the GENEROUS model for each such drug identified above;

d. Confirming whether the price listed above is lower than the lowest net price Pfizer currently offers to any state Medicaid program for such drug (including both statutorily required rebates under the Medicaid Drug Rebate Program and any supplemental rebates).

4. Please populate Table 2 by:

a. Listing all drugs marketed in the United States under labels of Pfizer subsidiary or affiliate companies;

b. Identifying which drugs among those listed above are subject to the Medicaid part of your agreement with the Trump administration and/or will be included in the GENEROUS model;

c. Providing the second lowest country specific average net price on each drug identified above over the last 12 months from the following countries: the United Kingdom, France, Germany, Italy, Canada, Japan, Denmark, and Switzerland;

d. Providing the net price available to state Medicaid programs under your agreement with the Trump administration and/or the GENEROUS model for each such drug identified above; and

e. Confirming whether the price listed above is lower than the lowest net price Pfizer currently offers to any state Medicaid program for such drug (including both statutorily required rebates under the Medicaid Drug Rebate Program and any supplemental rebates).

5. If Pfizer is effectuating the Medicaid components of your agreement with the Trump administration through a method other than the GENEROUS model:

a. Please explain how state Medicaid programs would receive any additional discounts or rebates on the relevant drugs.

b. In order to access any additional discounts on Pfizer drugs under the agreement, would state Medicaid programs need to agree to any conditions related to coverage, formulary placement, or utilization management for such drugs? If yes, would states have to opt into the agreement with respect to the entire bundle of drugs subject to the arrangement? Or could states make separate decisions with respect to each individual drug?

c. How would any additional discounts or rebates relate to the statutorily required rebates under the Medicaid Drug Rebate Program or supplemental rebates obtained by state Medicaid programs?

States need timely access to this information in order to make urgent state budgetary decisions due to the loss of Medicaid funding, including during special sessions and in preparation of budgets for the upcoming state fiscal year, and prioritize preserving patient access to health care. Therefore, we ask that you provide this information no later than January 30, 2026.

Sincerely,

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