FOCUS: Banquets and Billions — How AstraZeneca Secured Its U.S. Drug Deal with Trump

When AstraZeneca CEO Pascal Soriot stood beside President Donald Trump in the Oval Office on Friday as Trump unveiled a deal aimed at cutting drug prices for millions of Americans, he looked calm and confident — the picture of a man whose persistence had paid off.

That moment marked the culmination of months of public and private meetings between AstraZeneca executives and Trump administration officials, according to three people familiar with the talks. The negotiations — which began soon after Trump’s election victory last November — stretched late into the night in their final hours.

“You kept me and my team awake all night,” Soriot joked to Trump. “But it was worth it.”

A Royal Dinner and a Strategic Courtship

The 66-year-old French-born Australian’s success made AstraZeneca the first non-U.S. drugmaker to reach such a deal with Trump — and helped shield the Anglo-Swedish company from potential U.S. import tariffs that threatened the global pharmaceutical industry.

Soriot’s efforts cemented his reputation as one of the few foreign executives able to win Trump’s ear at a time when many CEOs were struggling with the president’s sudden policy shifts.

Trump has long argued that Americans pay far more for medicines than people in other wealthy nations — often three times as much, according to studies — and had threatened tariffs of up to 100% unless companies cut prices by September 29.

Just a week after Trump’s election win, AstraZeneca launched a charm offensive. On November 12, it announced a $3.5 billion expansion of its U.S. manufacturing and research operations.

According to one source, Soriot met Trump as recently as September 18 at a royal banquet at Windsor Castle, and over the summer he held at least three meetings — in the U.S. and U.K. — with Commerce Secretary Howard Lutnick.

Soriot also cultivated a close relationship with Virginia Governor Glenn Youngkin, a prominent Trump ally, resulting in a $4.5 billion plant deal that went from initial talks to signing in just over a month. The day before the White House signing, Soriot and Youngkin stood side by side at the groundbreaking ceremony.

“Youngkin’s ambitions and ties to the administration clearly helped,” said one of the sources. “The Virginia facility showed both sides were aligned.”

“A Very American Company”

Following AstraZeneca’s deal — and a similar one a week earlier with Pfizer — Wall Street analysts now expect other drugmakers to pursue their own agreements with the Trump administration in the coming weeks.

Shore Capital analyst Sean Conroy noted that Soriot, who has publicly supported Trump’s stance on drug pricing and once called AstraZeneca a “very American company,” had smartly positioned the firm in Washington.

“The messaging fits perfectly with Trump’s ‘Most Favored Nation’ agenda on drug prices,” Conroy said.

Concessions, but a Clear Win for AstraZeneca

While AstraZeneca is less exposed to U.S. tariffs than many peers due to its existing American production base, tighter pricing controls and regulatory pressure in the U.K. gave it a strong incentive to secure a U.S. deal.

Britain accounts for only a small share of the company’s revenue, but AstraZeneca remains headquartered and primarily listed in London, where it is the largest company on the FTSE 100 index.

Unlike the U.K., U.S. officials have been actively courting investment from companies like AstraZeneca, offering both political and logistical support.

In July, the firm announced a $50 billion U.S. investment plan, followed by a decision in late September to pursue a full U.S. stock listing alongside its London one — a move widely seen as a nod to Washington.

By the time Pfizer signed its own deal on September 30, AstraZeneca was already close to finalizing its agreement. Soriot flew to the U.S. early last week for final talks that stretched until the eleventh hour.

Sources said the Virginia plant deal helped smooth relations and paved the way for Friday’s announcement. Ultimately, AstraZeneca agreed to modest price concessions on some Medicaid drugs and pledged to expand local production, but the overall outcome was viewed internally as a major win.

Analysts say the arrangement brings clarity without materially hurting expected earnings. AstraZeneca is targeting $80 billion in revenue by 2030, about half of which is expected to come from U.S. sales.

As one source put it:
“Friday’s deal was the final piece of the puzzle.”