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President Trump signed an executive order Sunday that he says lowers prescription drug prices "by putting America first," but experts say the move is unlikely to have any immediate impact. The move comes nearly two months after the president signed a different executive order with the exact same name, but held it back to see if he could negotiate a better deal with drug companies. "If these talks are successful, we may not need to implement the fourth executive order, which is a very tough order for them," Trump said at the time. (Keith, 9/13)

The policy vastly expands an older, controversial drug pricing policy that Trump has been teasing for months. Effectively, it will force drug makers to offer their medicines to Medicare at the same prices they do in other countries, as a so-called most favored nations policy. Where an earlier version would only have applied to Part B drugs, which are administered in doctors offices, the new version also applies to Part D drugs, which are sold in pharmacies. (Florko, 9/13)

The order directs federal health officials to carry out demonstration projects for Medicare Part B, a move that would bypass the monthslong process of rulemaking and could start the price cuts before Election Day. It also would develop a similar rule for Medicare Part D, or those drugs that patients pick up at the pharmacy counter. The Part D rule would apply to drugs without much competition for which seniors pay prices higher than those in comparable OECD countries. (Owermohle, 9/13)

Though Trump has slammed socialist health care systems that exist in other countries and attacked his Democratic rivals for seeking to implement such a setup here, he celebrated linking US prices to peer nations' lower costs. "Just signed a new Executive Order to LOWER DRUG PRICES! My Most Favored Nation order will ensure that our Country gets the same low price Big Pharma gives to other countries," he tweeted Sunday. "The days of global freeriding at America's expense are over ... and prices are coming down FAST! Also just ended all rebates to middlemen, further reducing prices." (Luhby, 9/13)

The order, part of Mr. Trump’s broader focus on prescription drugs ahead of the November election, is unlikely to have an immediate effect because it requires federal rulemakings that could take months to complete. But if Mr. Trump wins a second term and goes ahead with the rules with wide applications, the move could be significant, since most developed nations have far lower drug prices than the U.S. does. (Restuccia and Burton, 9/13)

The order revokes a similar order that only would have applied to outpatient drugs, which the White House refused to release for more than seven weeks as the administration tried to force drugmakers to the negotiating table. "Negotiations did not produce an acceptable alternative, so the President is moving forward," White House spokesman Judd Deere said. (Cohrs, 9/13)

One of the world’s largest drug companies has been aggressively raising prices even as it received hundreds of millions of dollars of U.S. government aid to develop a COVID-19 vaccine. AstraZeneca, which the Trump administration has celebrated for its vaccine work, boosted prices despite renewed promises by President Trump this summer to keep drug costs in check. (Levey, 9/14)