At a Glance
- 14 pharma companies agreed to “most-favored-nation” pricing tied to lower overseas rates
- Cash buyers on the new TrumpRx portal may see list-price drops up to 90%
- Most private-insurance and Medicare patients won’t benefit from the agreements
- Why it matters: Millions who rely on insurance, plus Medicaid recipients with minimal copays, will see little or no savings
President Trump’s freshly struck agreements with drugmakers are drawing applause for eye-popping discounts, yet policy specialists say the vast majority of Americans will notice almost no change in what they actually pay.
What Was Announced
Since late September the White House has announced 14 individual pacts-covering brands such as Januvia, Plavix, Repatha, Xofluza, Epclusa, Mayzent, Wegovy and Zepbound-that promise U.S. prices matching the lower amounts paid in other wealthy nations. Companies receive tariff relief in return.
- Medicaid programs are slated to get the reduced rates
- Uninsured or cash-paying customers can order through a new online storefront, TrumpRx
- Some list-price reductions are dramatic: hepatitis-C drug Epclusa will drop from $24,920 to $2,425 for a course of treatment
Who Wins-and Who Doesn’t
The deals leave out most insured patients. Juliette Cubanski of KFF notes that people with coverage will usually pay less through their existing pharmacy benefit than via the cash portal. Stacie Dusetzina of Vanderbilt agrees the platform could help the nation’s 26 million uninsured, but adds that even steep markdowns may stay out of reach.
> “A 50% discount on a $500 drug…is still $250 out of pocket every month,” Cubanski said.
Medicaid recipients already face minimal or no copays, so lower state invoices won’t reach the pharmacy counter. Richard Frank of Brookings says the agreements are hard to judge because virtually nothing beyond press releases has been published.
Unknown Details-and Rising List Prices
Key facts are still missing:
- Full roster of covered medicines
- Effective dates (the White House says TrumpRx prices begin “early this year”)
- Projected taxpayer or patient savings
Meanwhile, manufacturers have raised prices on more than 350 brand-name drugs by an average of roughly 4% this year, according to 3 Axis Advisors data cited by Reuters.
Key Takeaways
- Only cash buyers without insurance are likely to see large, immediate savings
- Medicare and commercial-plan copays won’t change under these deals
- Medicaid already pays the lowest U.S. prices; enrollees won’t pocket extra relief
- Without public contracts, experts can’t verify whether announced cuts are new or recycled rebates
Until formal documents surface and more widely used medicines are included, analysts say the headline savings will have a “tiny” footprint on the nation’s total drug spending.
