OPINION:
On Thursday, Japanese Prime Minister Sanae Takaichi arrives in Washington for her first official visit to the White House. The agenda will be inclusive, covering issues such as defense spending, semiconductor investment, rare earths and agriculture.
That breadth reflects a deep reality: that Japan is one of the most important U.S. partners, a cornerstone of Indo-Pacific security and a major investor in American communities.
As the two allies look to strengthen their economic partnership, one issue deserves far more attention than it typically gets: the price Japan pays for American-made prescription drugs.
For decades, Japan has been one of the world’s most aggressively underpriced markets for innovative pharmaceuticals. In fact, its drug prices are roughly 25% of American prices for the same brand-name medicines, according to Rand Corp. data.
The Japanese Ministry of Health mandates biennial price cuts, imposes “market expansion repricing” that slashes prices when drugs succeed and, critically, has planned the extension and tightening of the drug assessment regime that punishes pharmaceutical companies for developing new treatments patients need.
This is the textbook definition of foreign exploitation. American families, employers and taxpayers bear the overwhelming cost of pharmaceutical innovation, funding roughly 78% of global drug research and development, while wealthy nations enjoy the benefits at a fraction of the price.
The U.S. accounts for 67% of global sales of new brand-name drugs, while Japan, the world’s third-largest economy, contributes a fraction of its fair share.
As a physician, I have seen firsthand what it means when patients cannot access the treatments they need and how trade policy shapes those outcomes. President Trump has been right to call out this imbalance and has shown that his administration knows how to solve this problem. There is now a proven model.
In December, the U.S. struck a historic pharmaceutical pricing agreement with Britain, in which the National Health Service committed to increasing its payments for innovative medicines by 25%. In exchange, Britain secured zero percent tariffs on pharmaceutical exports. It was a genuine win for both sides.
There is no reason the same logic cannot apply to Japan.
This is not about punishing an ally. Japan is a collaborator in semiconductors and clean energy, but a true partnership means shared responsibility. When Japan’s government-controlled pricing system forces American companies to sell innovative treatments at a loss, or not sell them at all, it undermines the innovation ecosystem that benefits patients in both countries.
A fairer pharmaceutical pricing agreement would strengthen the alliance, not strain it. Japanese patients would gain faster access to breakthrough therapies currently bypassing their market entirely, and American families would have the cost of global drug development distributed more fairly.
The Takaichi visit creates a natural opening to put pharmaceutical pricing on the bilateral agenda. The British agreement provides a clear template for how meaningful commitments on net pricing and market access, in exchange for favorable tariff treatment, can work.
Japan already has secured a commitment that its pharmaceutical exports will face tariffs no greater than those of any other country, but branded drug pricing has not been addressed in the existing framework. The ingredients for a deal are there. Japan wants certainty on tariffs. The U.S. wants fairness in pricing. That is the foundation of every successful negotiation.
Mr. Trump has made clear that no American should pay more for a prescription drug than a citizen of any other wealthy country. Ms. Takaichi has said she wants to deepen the U.S.-Japanese economic partnership. This week’s summit is an opportunity to advance both goals simultaneously.
Trade talks with Japan have produced agreements on semiconductors, agriculture and defense. For the benefit of both countries, it is time to add pharmaceuticals to the list.
• Michael C. Burgess, M.D., is a former U.S. representative from Texas, a member of the GOP Doctors Caucus and founder of the Healthcare Caucus.
Please read our comment policy before commenting.