Don’t Buy Trump’s SOTU Claims on Drug Prices
In his State of the Union speech, President Trump is expected to tout progress from his administration on lowering drug prices for Americans, but the rhetoric will not match the reality. Here are the facts:
President Trump and congressional Republicans gave prescription drug corporations an $8+ billion payout out of the pockets of taxpayers and cancer patients.
President Trump and congressional Republicans’ Big Ugly Bill included language to exempt and delay negotiations for drugs that would have otherwise been selected for negotiations this year, including Keytruda, Darzalex and Opdivo. These exemptions are projected to reduce savings from the negotiation program by $8.8 billion or more. Additionally, the tens of millions of Americans whose health insurance coverage was ripped away by the Big Ugly Bill will also lose the drug coverage from their insurance.
President Trump has proposed to further weaken Medicare drug price negotiations by prohibiting negotiations on all medicines until at least 11 years after first receiving FDA approval, meaning negotiated prices would not be available to Medicare and its beneficiaries for at least 13 years. This would effectively exclude many of these medicines from negotiations entirely, or shorten the period patients have access to lower negotiated prices to only one or two years before generics enter the market, blunting the impact of the law, potentially costing seniors and Medicare tens of billions more each year.
Trump’s CMS also choose to not to finalize plans to combine intravenous and subcutaneous formulations of drugs for Medicare negotiation. If they continue to exclude this policy, it will lead to more pharma gaming and monopoly extending, making it harder for the program to achieve savings for seniors and people with disabilities.
For most people, TrumpRx will not provide any relief from high drug prices. Others may be tricked into paying more for prescription drugs.
Nearly half of the drugs listed on TrumpRx (20 out of 43) have generics already approved by FDA that can be purchased more cheaply than the “discount” prices on TrumpRx. For some of these drugs, the difference can amount to hundreds of dollars per fill. Most of the products listed on TrumpRx are decades old; the median time on the market of the listed drugs is 26 years.
In the vast majority of cases, it will be cheaper for patients with insurance to use their insurance instead of TrumpRx. Insurance typically covers most of the drugs listed on TrumpRx with low out-of-pocket costs. For insured patients, going through TrumpRx could provide a double whammy of higher drug costs and those costs not counting toward insurance deductibles or out of pocket maximums.
TrumpRx claims to provide “the world’s lowest prices on prescription drugs”, but prices remain higher than in other wealthy countries. Wegovy deals on TrumpRx start at $199 for the first two monthly fills of the lowest dose and then rise to $349 per month; coupons must be used by the end of March 2026 to secure this deal. Meanwhile, Wegovy can be purchased for $186 in Denmark, $137 in Germany, and $92 in the United Kingdom.
Other components of the secret deals with drug corporations announced by the White House won’t help most patients, either.
President Trump and HHS Secretary RFK Jr. pledged ‘radical transparency.’ Instead, they’ve given us secret deals with drugmakers, making it impossible to determine whether they will lower some drug prices or if the terms are designed to protect pharma or to be easily gamed by them. The drug industry, Wall Street analysts and even CMS Administrator Oz have all predicted minimal financial impact from Trump’s dealmaking with pharma, suggesting that these agreements will have little impact on U.S. drug pricing and affordability. Dr. Oz suggested drug companies helped “design a plan that doesn’t hurt [them].”
As part of the deals, President Trump claims he got pharma companies to invest $400 billion in U.S. manufacturing since January 2025. But drug companies announced most of these investments prior to Trump’s presidency. About 60-70% of the $400 billion reflect previously planned or accelerated projects.
Regarding so-called “most-favored nation” prices offered to Medicaid, the Trump Administration has provided little transparency and thus it is difficult to evaluate the potential impact, but Medicaid already typically gets the best price on drugs in U.S. Medicaid beneficiaries don’t pay out-of-pocket drug costs. Depending on the structure of the arrangement, a drug corporation may even avoid costly inflationary rebates it would otherwise be obligated to pay, as media reports may be the case regarding Eliquis.
In exchange for these supposed concessions, the Trump Administration is attempting to bully other countries into adopting higher prescription drug prices, through trade and other pressures. But higher drug prices in other countries would do nothing to lower drug prices in the United States; prices are relatively lower in other countries because they have more effective systems in place to constrain big pharma’s monopoly pricing, such as national health care systems that negotiate prices on all medicines at launch or shortly after.
Meanwhile, the Trump Administration is taking an axe to medical innovation. Cuts to NIH, American research universities and changes at the FDA under President Trump all jeopardize America’s scientific enterprise and new drug discovery.
Conclusion
The bottom line is that that a quarter of Americans struggle to afford their drug costs and the vast majority of these people will not be helped by TrumpRx or other Trump Administration initiatives, despite Trump’s SOTU claims.
We need reforms to dramatically lower drug prices for everyone, not backroom deals and websites with exaggerated claims and limited reach.
Instead of phony solutions like TrumpRx, policymakers can save hundreds of billions of dollars and ensure Americans have access to fair drug prices by building on the progress of the Medicare Drug Price Negotiation Program to:
- Limit Medicare-negotiated drug prices based on what other countries pay for the same drugs.
- Expand access to Medicare-negotiated prices to people who get their insurance through their employer or the private market.
- Expand and lower the annual out-of-pocket cap for prescriptions so tens of millions more Americans with Medicare and with private insurance benefit from lower drug costs.
- Negotiate prices on all brand name drugs, including newly launched treatments, not just a limited number of drugs that have been on the market for nearly a decade or more.