Negotiations between the Trump administration and pharmaceutical companies on lowering U.S. prescription drug prices to match those of other countries appear to be ongoing despite the deadline passing.

President Donald Trump gave 17 major pharmaceutical companies a Monday deadline to begin voluntarily implementing a “most favored nation” pricing program for prescription drugs, which would bring U.S. drug prices in line with those of other developed nations.

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Several pharmaceutical companies told the Washington Examiner on Monday that they are still negotiating with the Trump administration over pricing.

In a letter to the companies sent this summer, the president requested that companies start providing MFN prices to Medicaid patients and raise international prices to reinvest in lowering prices for American patients. He also called for drugmakers to provide direct-to-consumer purchasing for patients at MFN prices and guarantee that any new drugs would be launched with MFN pricing.

So far, only Eli Lilly has announced that it will raise prices for European markets to lower prices in the United States. Bristol Myers Squibb also announced this month that it will be matching the prices for its new schizophrenia drug in the U.S. and the United Kingdom.

The White House did not respond to the Washington Examiner’s request for comment on the status of negotiations for MFN pricing on a wider array of products.

According to a fact sheet published by the White House when Trump set the deadline, Americans pay three times more for brand-name prescriptions than people in other developed countries. The U.S. also makes up 75% of global pharmaceutical profits despite having less than 5% of the world population.

In an apparent attempt to comply with Trump’s deadline, two pharmaceutical companies have established new direct-to-consumer price reductions for patients regardless of insurance coverage.

France-headquartered drugmaker Sanofi announced Friday that it would offer a 30-day supply of any of its insulin products for $35 to all U.S. patients with a valid prescription.

Adam Cluck, Sanofi’s head of U.S. corporate affairs, said in a press release that the pricing program “builds on an idea first championed by President Trump to lower costs for American patients at the pharmacy counter.”

On Monday, the Swiss pharmaceutical company Novartis announced that it would launch a similar direct-to-patient platform for its product Cosentyx, a drug that reduces symptoms of psoriatic arthritis, psoriasis, and other immune-mediated inflammatory diseases.

Novartis and Sanofi did not respond to the Washington Examiner’s request for comment.

Several other companies put on notice by the Trump administration told the Washington Examiner that they are actively negotiating with senior administration officials on policies to lower drug prices for U.S. consumers.

A Merck spokesperson, for example, said the company “supports raising foreign prices and lowering U.S. prices” and that foreign prices set by socialized medicine systems “unfairly disadvantage American patients and threaten continued investment in breakthrough life-saving and life-improving research.”

EMD Serono, which specializes in oncology, endocrinology, and fertility care, told the Washington Examiner that it is in “close contact with the US administration” and that its first priority is “that patients worldwide continue to benefit from our innovations without disruption.”

Gilead, based in Foster City, California, released a similar statement on Monday highlighting its billions of dollars of investment in U.S.-based innovation, including employing more than 10,800 people in US-based research and development.

Gilead is “actively engaging on innovative solutions like direct-to-patient offerings for high volume, high rebate medicines,” according to its statement, but it did not specify that it would be launching any new price-lowering programs.

In July, Centers for Medicare & Medicaid Services Administrator Mehmet Oz, along with Food and Drug Administration Commissioner Marty Makary, wrote an op-ed in the Wall Street Journal that their chief tactic in advancing the broader “Make America Healthy Again” agenda has been voluntary commitments from corporations.

But last week, a notice was posted on a government regulatory website indicating that the administration is in the early stages of the rulemaking process on prescription drug pricing.

The proposed policy titled “Global Benchmark for Efficient Drug Pricing (GLOBE) model” is listed as falling under the jurisdiction of the CMS. The policy is listed as pending “regulatory review,” and no additional details were provided in the release.

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Two unnamed pharmaceutical lobbyists told Reuters last week that they expected the rule to mirror a 2020 rule from the first Trump administration that lowered the price of the 50 most expensive drugs for the Medicare Part B program to match the lowest price paid by a group of peer countries. The 2020 policy was blocked by the courts.

The CMS did not respond to the Washington Examiner’s request for comment on the proposed policy.