Fact Check: Trump’s State of the Union Drug Pricing Fiction Versus Reality
Trump Fiction: “I’m also ending the wildly inflated cost of prescription drugs like has never happened before. Other presidents tried to do it, but they never could. … But I got it done, under my just-enacted most-favored nation agreements, Americans who have for decades paid by far the highest prices of any nation anywhere in the world for prescription drugs will now pay the lowest price anywhere in the world for drugs, anywhere, the lowest price.”
Reality: Trump’s secretive most-favored nation agreements are expected to have little impact on U.S. drug pricing and affordability. Drug companies and Trump’s own head of Medicare and Medicaid have admitted as much.
CMS Administrator Oz said drug companies “help[ed] design a plan that doesn’t hurt you.”
The White House-pharma company “deals” largely revolve around tying some Medicaid drug prices to those paid in other countries. Medicaid patients won’t see any benefit from this change and there’s even some concern the agreements could raise the prices paid by states and taxpayers.
President Biden and Congressional Democrats achieved the biggest policy win on U.S. drug pricing with the 2022 Inflation Reduction Act’s Medicare drug price negotiations program that is expected to save $100 billion between 2026 and 2031. As CMS continues to implement the program, successfully negotiating an estimated $12 billion in annual savings in drugs selected in its second year, Trump has simultaneously been busy aiding pharma’s attempts to weaken that historic achievement, including by signing into law Republicans’ Big Ugly Bill which will exempt and delay negotiations on some of the priciest cancer medicines needed by seniors, costing Medicare about $8.8 billion.
Other countries continue to get better deals than the U.S. on drugs because they negotiate for the cost of most medicines on behalf of all of their citizens. Trump and congressional Republicans could build on the Medicare Drug Price Negotiation Program to truly bring more American’s drug prices aligned with those in other countries. But they’ve been too busy giving handouts to big pharma.
Trump Fiction: “I took prescription drugs, a very big part of health care, from the highest price in the entire world to the lowest. That’s a big achievement. The result is price differences of 300, 400, 500, 600% and more, all available right now at a new website called TrumpRx.gov — and I didn’t name that one, either, by the way.”
Reality: TrumpRx doesn’t contain the lowest prices in the world for prescription drugs and in most cases they’re not even close to the best deals for U.S. patients.
There are just 43 of more than 20,000 FDA-approved prescription drugs on TrumpRx. Most Americans won’t find their medicines on TrumpRx. When they do, they’d likely be better off purchasing them outside of the website using their health insurance benefits. For most Americans without insurance the costs of drugs on TrumpRx are still unaffordable.
Nearly half of the drugs listed on TrumpRx (20 out of 43) have generic versions. Patients who don’t have insurance coverage can often save hundreds of dollars per fill by buying generic versions through other pharmacy programs.
Trump’s spoke about health care for less than five minutes in his nearly two-hour speech. Perhaps that’s because his presidency has done more to harm than help Americans’ health.
Trump’s Big Ugly Bill ripped health insurance coverage from tens of millions of Americans.
Trump and Congressional Republicans’ failure to extend Affordable Care Act subsidies means millions of Americans saw their health premiums skyrocket in 2026, costing them thousands more dollars a year and in some cases forcing them to forgo health insurance entirely.
Trump has gutted America’s public health and medical research infrastructure, jeopardizing the discovery of future medical advancements and cures.
And Trump appointed an anti-vaccine activist to lead the Department of Health and Human Services, contributing to the revival of once nearly eliminated and deadly illnesses in the U.S. like measles. Other infectious diseases are expected to make a comeback in Trump’s anti-science America.