WASHINGTON — President Donald Trump on Monday signed a sweeping executive order setting a 30-day deadline for drugmakers to lower the cost of prescription drugs in the U.S. or face new limits over what the government will pay.

The order calls on the Department of Health and Human Services, led by Robert F. Kennedy Jr., to broker new price tags for drugs. If a deal is not reached, a new rule will kick in that will tie the price of what the U.S. pays for medications to lower prices paid by other countries.

“We’re going to equalize,” Trump said during a Monday morning news conference. “We’re all going to pay the same. We’re going to pay what Europe pays.”

It’s unclear what — if any — impact the Republican president’s executive order will have on millions of Americans who have private health insurance. The federal government has the most power to shape the price it pays for drugs covered by Medicare and Medicaid.

The U.S. government annually spends hundreds of billions of dollars on prescription drugs, injectables, transfusions and other medications through Medicare, which covers nearly 70 million older Americans; Medicaid covers nearly 80 million poor and disabled people in the U.S.

Ahead of the signing, the nation’s leading pharmaceutical lobby on Sunday pushed back against Trump’s plan, calling it a “bad deal” for American patients. Drugmakers have long argued that any threats to their profits could impact the research they do to develop new drugs.

“Importing foreign prices will cut billions of dollars from Medicare with no guarantee that it helps patients or improves their access to medicines,” Stephen Ubl, the president and CEO of PhRMA, said in a statement. “It jeopardizes the hundreds of billions our member companies are planning to invest in America, making us more reliant on China for innovative medicines.”

Trump’s so-called most favored nation approach to Medicare drug pricing has been controversial since he first tried to implement it during his first term. He signed a similar executive order in the final weeks of his presidency, which called for the U.S. to only pay a lower price that other countries pay for some drugs — injectables or cancer drugs given through infusions — administered in a doctor’s office.

That narrow executive order faced hurdles, with a court order that blocked the rule from going into effect under President Joe Biden’s administration. The pharmaceutical industry argued that Trump’s 2020 attempt would give foreign governments the “upper hand” in deciding the value of medicines in the U.S.

Trump repeatedly defended pharmaceutical companies, instead blaming other countries for the high price Americans pay for drugs, during a wide-ranging speech at the White House on Monday.

He did, however, threaten the companies with federal investigations into their practices and opening up the U.S. drug market to import more medications from overseas.

The White House did not release an analysis of how much money his order would save or which drugs would be impacted.