> At a Glance
> – President Trump’s team has struck tariff-relief deals with 14 drugmakers since Sept. 30.
> – The agreements adopt “most-favored-nation” pricing for Medicaid and a new cash-pay portal called TrumpRx.
> – List-price cuts reach 90% on some drugs, yet most people with private insurance or Medicare see no change.
> – Why it matters: The splashy discounts apply to a narrow slice of prescriptions, leaving typical out-of-pocket costs largely untouched.
President Trump is touting major drug-price victories, but early details suggest the savings will reach only a small subset of patients and may not lower America’s overall medication spending.
What’s Actually in the Deals
Under the agreements, companies that include Merck, Sanofi, Amgen, Genentech, Gilead, Novartis, Novo Nordisk and Eli Lilly will tie U.S. prices to lower amounts paid abroad for a still-undisclosed list of medicines. Medicaid programs would benefit, and cash customers could order through the upcoming TrumpRx site.
Announced examples:
- Epclusa (hepatitis C) will drop from $24,920 to $2,425 cash.
- Wegovy/Zepbound (weight-loss) will start at $350 a month and fall to $250 within two years.
- Januvia (diabetes) and Repatha (cholesterol) are also included, though Januvia is already in Medicare’s separate price-negotiation queue.
Who Benefits-and Who Doesn’t
Juliette Cubanski of KFF notes that people with insurance will usually pay less through their plans than via TrumpRx. Stacie Dusetzina of Vanderbilt says the portal could help the nation’s 26 million uninsured, but even 50% off a $500 brand still leaves $250 a month-out of reach for many.
Medicaid recipients, who already pay little or nothing, won’t feel a difference either, and Richard Frank of Brookings warns the touted cuts could merely repackage rebates that manufacturers were planning anyway.
| Drug | Old Cash Price | TrumpRx Price | Generic? |
|---|---|---|---|
| Epclusa | $24,920 | $2,425 | Yes |
| Plavix | Not listed | Discounted | Yes |
| Xofluza | Not listed | Discounted | No |
Questions Still Unanswered
- The full roster of covered drugs remains secret.
- No written contracts have been released.
- The administration has provided no total savings estimate.
Art Caplan of NYU adds that some chosen products, such as Xofluza, treat acute conditions and must be taken within 48 hours, making mail-order fulfillment tricky.
Key Takeaways
- Discounts focus on a limited basket of brand drugs.
- Most insured patients will continue to pay their usual copays or coinsurance.
- Without public documents, the deals’ scope and enforceability are unclear.
Bottom line: The headline numbers look dramatic, but the fine print suggests routine pharmacy bills for most Americans will stay about the same.
