Short Take: The Trump administration has announced agreements with 14 drugmakers to tie some U.S. drug prices to those in other wealthy countries and to offer cash discounts via TrumpRx. Experts say most privately insured and Medicare patients are unlikely to benefit because their plan prices won’t change, and Medicaid enrollees already pay little or nothing at the pharmacy. With few public contracts or a full drug list, the deals’ real impact remains uncertain, and industry price hikes and rising premiums could offset any savings.
Trump’s Drugmaker Deals Promise Big Discounts — But Most Americans May Not See Relief
A pharmacist in Provo, Utah in August. President Donald Trump has struck deals with 14 drugmakers in exchange for tariff relief. (George Frey / Bloomberg via Getty Images file)
President Donald Trump’s administration has announced agreements with 14 drugmakers that aim to lower certain U.S. drug prices by linking them to prices paid in other wealthy countries and by offering cash-pay discounts through a new platform called TrumpRx. But health policy experts say the deals — many of which exist only as press releases so far — are unlikely to produce broad savings for most Americans.
What the deals propose
Since Sept. 30, the White House has publicized deals with 14 manufacturers in exchange for tariff relief. The announced agreements use a “most favored nation” pricing approach, tying some U.S. prices to those in other wealthy countries and reducing what Medicaid would pay for covered drugs. The deals also promise lower cash prices for patients who pay out of pocket through TrumpRx.
Who could benefit — and who probably won’t
Experts say the direct benefits will likely be limited to people who pay cash for prescriptions or those with high-deductible plans. Most people with private insurance or Medicare typically will continue to pay the costs determined by their plans, not the TrumpRx cash prices. Medicaid enrollees already face minimal or no copayments, so those patients are unlikely to see savings at the pharmacy counter even if states obtain lower net prices.
“Generally speaking, most people with insurance coverage will continue to be better off using their insurance to obtain medications rather than purchasing through the TrumpRx direct-to-consumer portal,” said Juliette Cubanski, deputy director of the Program on Medicare Policy at KFF.
Limited transparency and lingering questions
Many key details remain undisclosed. Critics note there is little on paper beyond press statements: no full lists of covered drugs, few public contracts, and limited information on how the pricing rules will be enforced. “There’s virtually nothing on paper about them except for press releases,” said Richard Frank, director of the Center on Health Policy at the Brookings Institution.
Drugs named and price examples
The White House has publicly named several medicines tied to the agreements, including Merck’s diabetes drug Januvia, Sanofi’s blood thinner Plavix, Amgen’s cholesterol therapy Repatha, Genentech’s flu antiviral Xofluza, Gilead’s hepatitis C treatment Epclusa, Novartis’ multiple sclerosis drug Mayzent, and the weight-loss drugs Wegovy (Novo Nordisk) and Zepbound (Eli Lilly).
Some announced discounts are large compared with list prices. For example, Epclusa’s list price of about $24,920 would be reduced to $2,425 for cash-paying patients on TrumpRx, according to the White House. Wegovy and Zepbound out-of-pocket monthly costs are reported to start near $350 and fall to $250 within two years from a current roughly $500 cash price.
Overlap With Existing Policies
Two named drugs are already part of Medicare price negotiations under the Inflation Reduction Act: Januvia was selected in the first round and Wegovy was selected in the second. That overlap raises questions about how the new deals would interact with or duplicate existing federal efforts to lower prices.
Experts’ concerns and market context
Several experts caution that manufacturers may choose which drugs to include in deals, likely avoiding those that would sharply cut revenue. Some drugs named are not among the costliest or already have generic versions (Plavix and Epclusa have generic alternatives). Others serve relatively small patient populations and therefore would have limited impact on overall drug spending.
Meanwhile, many manufacturers raised list prices this year — Reuters reported more than 350 brand-name price increases averaging roughly 4% — and Americans faced higher health insurance premiums as enhanced Affordable Care Act subsidies lapsed. Those broader trends could offset any patient-facing savings from the announced deals.
Bottom line and what to watch
For uninsured patients and people with high deductibles, TrumpRx could offer meaningful cash savings for select medicines. For most insured patients and Medicaid enrollees, the agreements — as currently described — are unlikely to change out-of-pocket costs. The impact will hinge on two things that remain unclear: a complete list of covered drugs and formal, binding contracts that specify how prices and rebates will be implemented.
The White House says some lower prices will appear on TrumpRx "early this year" and Medicaid pricing changes are expected "in the coming months," but officials have not released a comprehensive estimate of expected out-of-pocket savings.
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