Trump Rx prescription drug site ‘not a solution’ for many patients, experts say

The Trump administration has launched TrumpRx, but there are other sites offering discounts on more medications, and the new government site will appeal to a very limited group of patients, experts say.

Trump has promised reforms on the unusually high drug prices in the US, and he called the announcement “the largest reduction in prescription drug prices in history” at a press conference on Thursday. Yet the site only lists 43 medications, more than half of which are available in generic form at significantly cheaper prices elsewhere.

The site may make some weight loss and fertility drugs not covered by insurance more accessible, but overall “it is not a solution for high drug prices in the United States”, said Sean Sullivan, professor of health economics and policy and former dean of pharmacy at the University of Washington.

“Consumers can probably get a cheaper version of these medicines through insurance and their pharmacies, or via cash pay services like Cost Plus Drugs than by the deals offered through TrumpRx,” Sullivan said.

“Healthcare is really complicated in America, and even the supply of prescription drugs is really complicated in America, and this has added to the complexity, instead of reducing complexity,” said Rena Conti, associate professor of markets, public policy, and law at Boston University’s Questrom School of Business.

The best course is likely still to “ask your local pharmacist what the best deal is”, Conti said.

In the US, prices for all drugs – brand names and generics – were 2.7 times higher than in comparison countries in 2022, according to a report from the US Department of Health and Human Services (HHS). Eight in 10 adults say the cost of prescription drugs is “unreasonable”, and about three in 10 said they haven’t taken their medicines as prescribed because of the cost, according to the health policy nonprofit KFF.

Healthcare is set to become even more expensive as Republicans in Congress have proposed nearly $1bn in Medicaid cuts and allowed Affordable Care Act tax credits to expire.

As it currently stands, the limited offerings on TrumpRx seem unlikely to compete with established sites. Cost Plus Drugs, the low-cost medication site founded by billionaire Mark Cuban and radiologist Alex Oshmyansky, offers more than 2,000 drugs. TrumpRx is reportedly powered by GoodRx, a popular site offering coupons and price comparisons.

The medication Protonix, which treats gastrointestinal issues such heartburn, stomach ulcers and reflux, is listed by TrumpRx at $200.10, while the generic version costs $6.07 on Cost Plus Drugs. The medication Xeljanz, which treats rheumatoid arthritis, is listed as $1,518 on TrumpRx – but GoodRx points out that Xeljanz is free with most insurance plans.

“Most of them aren’t even the treatments of choice for many of the diseases,” Sullivan said. And most of the products are quite old; the median time on the market is 26 years, he pointed out. “These are drugs that the pharmaceutical industry has given up marketing a long time ago, like Protonix, for example.”

For some medications, TrumpRx offers coupons for patients to present at pharmacies, while others have links to buy directly from manufacturers or compounding pharmacies; those direct purchases usually don’t count toward out-of-pocket insurance maximums.

“This is not fundamentally altering access or furthering transparency at this point in time, except for a very few selected patients who are using a very limited set of drugs,” Conti said. A handful of drugs on the site are relatively affordable for people who typically pay out of pocket – especially fertility treatments, she said. Often these treatments are not covered by insurance, and prices are steep.

Gonal F, which helps stimulate ovulation, costs $168 on TrumpRx, compared to $432 on through Alto Pharmacy, according to GoodRx. “For very niche populations and very specific medication, at least in the case of infertility, it looks like this might be a good deal,” Conti said.

Yet making some medications cheaper does not make in vitro fertilization (IVF) more accessible to most patients, as the Trump administration has promised, since drugs represent only a fraction of the costs of IVF, Sean Tipton, chief advocacy and policy officer at the American Society for Reproductive Medicine, said in a statement.

“We are pleased to see fertility medications included in the TrumpRx portal,” he said. “There are, however, plenty of questions as to just how helpful this program will be.”

Weight loss drugs known as GLP-1s, under the names Wegovy, Ozempic, and Zepbound, are also available. “Zepbound looks like it’s a good deal. It’s also the exact same deal that’s being offered by going to Lilly Direct,” the manufacturer’s site, Conti said.

But the lower prices for Wegovy and Ozempic, both marketed by Novo Nordisk, expire in a month or two, and they are for the lowest dose, which most people do not stay on. “I fail to see how the Novo offer is really going to help people who want this drug,” Conti said.

Trump promised a savings of 578% for Novo Nordisk’s drugs, which would mean the company would pay patients to take the drugs. The site itself says the discount is 74 to 85% off the list price.

It’s “not surprising” that the administration’s description of the website “bears no relation to reality”, said Sarah Karlin-Smith, research director on access to medicines at Public Citizen. “They’re pretending they just rolled out the best thing ever to save Americans on drug prices, and in reality, many Americans, if they use this website, probably would actually spend more money on drugs than they needed to.”

More than what was listed, Conti questioned which drugs didn’t appear on TrumpRx. “There are only 43 drugs, and there’s 17 pharmaceutical manufacturers at least who have signed most-favored-nation deals. So where are the other drug companies and where are the other drugs?” she asked.

The project does nothing to address the underlying issues of medication pricing and healthcare access in the US, Sullivan said. “It just obfuscates what we really need to be doing,” he said. “It’s a distraction from what we need to be doing, which is thoughtful, careful policy approaches to managing drug costs and balancing that with investments for innovation in the US.”