The purpose of this executive order is to lower prescription drug prices to American patients. It directs the secretary of Health and Human Services to propose and seek comment on guidance for the Medicare Drug Price Negotiation Program (the government negotiates with the manufacturers for the prices Medicare will pay for medications) for initial price applicability year 2028 and manufacturer effectuation of maximum fair price under that program in 2026, 2027 and 2028. The executive order also directs the secretary to take steps to (a) implement a rule making plan and a payment model to improve the ability of Medicare to obtain better value for high cost prescription drugs and biological products covered by Medicare; (b) lower the cost of insulin and epinephrine to individuals with low incomes; (c) lower the prices of prescription drugs by increasing prescription drug importation; and (d) propose regulations to reduce costly care for seniors by ensuring that payment under the Medicare program is not encouraging a shift in drug administration volume away from physician office settings to more expensive hospital outpatient departments.