Since his second time period began, President Donald Trump has introduced, negotiated, or floated a flurry of initiatives geared toward taming the excesses of the pharmaceutical trade.
No shock. About 60% of American adults are “nervous about having the ability to afford prescription drug prices for themselves or their households,” a current KFF nationwide ballot confirmed. Greater than 80% think about the worth of prescribed drugs “unreasonable,” and most assist elevated regulation to decrease prices. People pay about 3 times as a lot as individuals in different international locations for a similar prescribed drugs.
Final July, Trump despatched letters to 17 drugmakers, demanding they voluntarily decrease drug costs. Then the president mentioned he’d negotiated with greater than a dozen pharmaceutical executives one after the other on the White Home. In December, he introduced that he had compelled them to conform to “most favored nation” pricing on Medicaid, the federal government protection for low-income People.
Then got here the unveiling of TrumpRx, a web site the place cash-paying sufferers might discover discounted medicines, and a promise to hurry biosimilar merchandise — generic variations of sure high-priced specialty medication — by reducing via FDA pink tape.
The scope of those grand gestures stays unsure. Nevertheless it’s definitely lower than what the announcement promised, partly as a result of many particulars of the negotiations, even which medication are coated, are hazy.
White Home spokesperson Kush Desai didn’t reply queries about TrumpRx.
Medicaid already buys medication at deep reductions. And different sufferers might nicely have higher choices via industrial drug low cost applications, which supply much more merchandise, or via their insurance coverage and related drug firm copayment playing cards.
So, for all Trump’s showmanship, the share of People more likely to profit from these choices stays slim, even when some individuals do come out forward.
“If it makes a distinction to any affected person, it’s a win,” mentioned Mark Cuban, a billionaire investor on his personal mission to carry down drug costs. He pointed to discounted pricing on TrumpRx for branded fertility medication and GLP-1 weight reduction medication for individuals with out insurance coverage or whose plans don’t embody protection. Cuban launched the Mark Cuban Value Plus Drug Co., often called Value Plus Medication, in 2022 to promote medication cheaply by eliminating middlemen — shopping for from factories and promoting on to shoppers. Many of the medication he sells are generics.
Aaron Kesselheim, a professor of drugs at Harvard Medical College whose analysis focuses on drug costs, mentioned the Trump bulletins are “one-off agreements made for publicity functions. They don’t change something about the best way medication are priced.”
He added: “The agreements are opaque and unenforceable.”
It was unclear, for instance, which medication can be offered at “most favored nation” costs or how precisely that was outlined. However, clearly, not all had been.
Doing the Math
46brooklyn, a consulting agency and information undertaking that tracks brand-name drug costs, discovered that near 1,000 model medication went up in value in January 2026. What’s extra, 2025 had the very best variety of listing value will increase ever. “This isn’t a fabric change, it’s enterprise as regular,” mentioned Antonio Ciaccia, the corporate’s co-founder.
Within the first week of 2026, Pfizer raised the listing costs of 71 medication by a mean of 5% and lowered the worth of just one, by 9.8%, the info undertaking discovered.
The largest win for sufferers has seemingly been the Trump administration’s quiet continuation of a Biden administration program: Medicare drug value negotiation for costly medication. The negotiated reductions on the preliminary 10 medication — from blood thinners to insulins to medicines for inflammatory problems — went into impact Jan. 1. With reductions in value of nicely over 50% on some merchandise, the estimated $6 billion in annual financial savings allowed this system to cap Medicare sufferers’ out-of-pocket spending on Half D prescribed drugs at $2,000 for 2025 and past.
An extra 15 high-priced medication — together with standard weight reduction and most cancers medication — had been topic to negotiation in 2025, with discounted Medicare costs taking impact subsequent 12 months. And 15 extra high-priced medication are set for negotiation this 12 months. All advised, the 40 negotiated drug costs are anticipated to avoid wasting Medicare nicely over $20 billion a 12 months.
At the same time as these reductions take impact, drug trade lobbyists have been working to restrict the impression, with some success. For instance, the One Huge Lovely Invoice Act exempts medication for uncommon ailments from negotiations.
Nonetheless, “that is historic as a result of it’s the primary time the US has negotiated costs, like each different developed nation,” Kesselheim mentioned. “And guess what? Innovation didn’t cease.”
After all, these reductions profit solely Medicare enrollees. The newer Trump administration initiatives assist another sufferers, however they’re restricted and require data of how you can entry the reductions.
Trump’s One-on-Ones
The president’s televised appearances with the heads of main drug corporations resulted in offers, however few, if any, will imply a lot to sufferers. For instance, after Trump met with Albert Bourla, CEO of Pfizer, the corporate introduced reductions on 30-plus medication. Bourla known as the deal “a win for American sufferers, a win for American management, and a win for Pfizer.”
The reductions are provided through TrumpRx, which, in flip, provide coupons co-branded on GoodRx.com, which already provides low cost coupons for a lot of a whole bunch of medicines.
Pfizer made hay of the deal, asserting it was a part of Pfizer’s broader, landmark most favored nation, or MFN, settlement with the U.S. authorities, enabling sufferers to pay decrease costs for his or her prescription medicines “whereas strengthening America’s position as the worldwide chief in biopharmaceutical innovation.”
Pfizer spokesperson Steven Danehy cited a press launch from September noting that the TrumpRx web site provides sufferers financial savings that “vary as excessive as 85%.”
Many of the listing options brand-name medication, competing with far cheaper generic variations from different producers, such because the cholesterol-lowering drug Colestid, which TrumpRx lists for “50% off” at $127.91. Generic variations price about $17 on the Value Plus web site.
This implies the branded corporations aren’t making a sacrifice by providing them at decrease prices as mirrored on Trump’s portal, mentioned Sean Tu, a patent legislation professional on the College of Alabama. “That’s a sale they’d not have made if not for TrumpRx.”
Others are very outdated medication, comparable to Cortef, or hydrocortisone, whose 5-milligram branded Pfizer model is listed at $45 on TrumpRx, half its listing value of $91.80. It sells for a lot much less on Cuban’s Value Plus web site. Nonetheless others, such because the $607.20 HIV therapy Viracept, are helpful solely together with different medication that aren’t discounted.
Final week, TrumpRx added AbbVie’s Humira, for years the world’s best-selling drug, at $950 a dose, down from an inventory value of almost $7,000. However Humira misplaced its patent safety in 2023, and biosimilars — primarily generic equivalents — have since come to market. Extra to the purpose, two of these biosimilars are listed on TrumpRx for as little as $207.60 a dose.
Since many of the TrumpRx merchandise can be found solely to clients with out insurance coverage who pay money, the arthritis drug Xeljanz’s drop from $2,277 to $1,518 a month would nonetheless go away it unaffordable.
A Few Notable Offers
The much-touted TrumpRx web site, launched Feb. 6, consists largely of Pfizer’s 30 medication (30 of roughly 85) with a smattering of reductions more likely to generate headlines.
These embody three fertility medication from EMD Serono, a subsidiary of the pharmaceutical big Merck KGaA, the most costly of which, Gonal-F, has an inventory value of $966 however is simply $168 per IVF cycle utilizing a TrumpRx coupon.
They are going to save ladies hundreds of {dollars} — though the general price of fertility therapy will proceed to place them past the attain of many, since medication signify solely a portion of the cost.
The TrumpRx reductions might scale back the $15,000-to-$25,000 price of a single fertility therapy cycle — ladies sometimes want two or three cycles to develop into pregnant — by about 10%, mentioned Sean Tipton, spokesperson for the American Society for Reproductive Medication. In some European international locations, every cycle prices about $3,000.
In trade for reducing these costs, EMD Serono acquired tariffs lifted on its principally overseas-produced drugs. It additionally received the correct to a sped-up FDA approval course of for a fertility drug it’s been advertising and marketing closely in Europe.
One other newsworthy providing on the positioning resulted from a take care of Novo Nordisk for Wegovy, its GLP-1 drug for weight reduction and diabetes, with the worth lowered to as little as $199 a month for the pen. (Many insurers cowl such medication just for diabetes, leaving those that are concerned with dropping pounds paying out-of-pocket. Zepbound, Wegovy’s Lilly & Co. competitor, can also be on the listing, at $299.)
Strain has been constructing on Novo and Lilly to decrease the U.S. value of their GLP-1 medication. The compounds have misplaced patent safety in India, and strain from clients shopping for abroad will seemingly enhance when generic Wegovy goes on sale in Canada, for as little as $73 a month, presumably this 12 months.
In the US, in the meantime, dozens of patents ought to maintain Wegovy generics off the market till 2039, mentioned professor Robin Feldman, a patent professional on the College of California Legislation-San Francisco. A current report from the analysis group I-Mak delved into a number of methods patent manipulation retains generics off the U.S. market lengthy after they’re out there in European international locations and Canada.
And whereas the Trump administration has vowed to approve biosimilars extra quickly to make sure extra competitors and decrease costs, that will not have a lot impression. The large hurdle in getting generics and biosimilars to market is commonly not FDA approval, however the time it takes to override the thickets of patents that U.S. legislation permits producers to deploy to guard their mental property.
For instance, in 2021, the FDA accepted a generic of Otezla, a well-liked drug for psoriatic arthritis, nevertheless it won’t hit the market till 2028. Its entry would require drugmakers to pay rebates to Medicare in the event that they charged this system greater than different developed international locations for “single supply” medication and biologics. That will primarily enable the Medicare program to piggyback on different international locations that negotiate the costs of a few of the costliest medicines. These applications are nonetheless going via the rulemaking course of and, once more, would profit solely these coated by the Medicare program and solely not directly.
The typical patient-consumer, if keen to pay money, might discover some bargains. However getting one of the best deal might take quite a lot of mixing and matching, forcing sufferers to develop into picky consumers, eyeing offers for important medicines as they’d for a carton of milk or eggs.
Information reporter Maia Rosenfeld contributed to this text.