WASHINGTON, April 16, 2025 (BSS/AFP) - US President Donald Trump signed an executive order Tuesday aiming to lower crippling drug prices by giving states more leeway to bargain-hunt abroad and improving the process for price negotiations.

Americans face the highest prescription drug prices in the world, leaving many people to pay partially out of their own pockets despite already exorbitant insurance premiums.

"This (order) will provide meaningful relief to seniors and low income individuals who depend on insulin and many, many more," a White House official told reporters.

"Furthermore, it will foster a more competitive prescription drug market to ensure the prices being charged to patients and the government are more aligned with the value they provide, rather than some quirk in the way that the government pays for them."

The order directs the Food and Drug Administration (FDA), which regulates prescription and over-the-counter pharmaceuticals, to allow more states to import medicines directly from countries with lower prices.

The administration of Trump's predecessor Joe Biden approved Florida's application to import from Canada last year but no other states were given the green light for their own deals.

The order also tweaks the Inflation Reduction Act (IRA) passed under Biden, which allowed the Medicare health insurance plan for seniors to negotiate the prices of certain drugs for the first time.

The aim of the changes is to eliminate the difference between price negotiation rules for pills and those for injectable drugs -- a disparity that critics argue could harm investment in the orally-administered products.

Under the IRA, Medicare could negotiate on prices for "small molecule" drugs that patients swallow, such as ibuprofen, nine years after FDA approval.

"Large molecule" biologics such as gene-based therapies and hormonal regulators could only be subject to negotiations after 13 years.

The order did not specify how the disparity would be addressed.

Officials said the edict also did not make use of a "most favored nation" status that would force pharmaceutical companies to offer their lowest prices in America.

Biden's IRA reforms led to the costs of 10 key medicines being cut in landmark negotiations with pharmaceutical firms.

Days before leaving office, the Democrat announced a further 15 drugs for which the government would negotiate lower prices with pharmaceutical companies, with the resulting prices taking effect in 2027.