Much of President Donald Trump’s campaign promises to lower drug prices in the U.S. were said to have been delivered through TrumpRx, a recently launched direct-to-consumer platform built on most-favored-nation pricing that benchmarks domestic prices against international rates.
But, according to a new report from The New York Times, TrumpRx’s claims of offering “the world's lowest prices on prescription drugs” might have some caveats. A review conducted by the NYT and German news organizations Süddeutsche Zeitung, NDR and WDR found that drug prices in Germany were lower than many listed on TrumpRx when directly compared.
Last May, the president issued an executive order mandating MFN drug pricing while calling out “inflated prices” in the U.S. that force American patients to pay “almost three times more” for the same medicines than those in other developed nations. Trump, in a Truth Social post at the time, insisted that this order would see prescription drug prices reduced by 30% to 80%.
Seventeen of the world’s largest drugmakers were then sent letters that demanded them to match their U.S. drug prices with other nations’ and to sell their products through DTC platforms. Pfizer was the first to sign on to the arrangement, with its peers following suit.
In February, Trump wrapped his MFN pricing deals into action with the launch of drug purchasing platform TrumpRx.
The website states that “the days of Big Pharma price-gouging are over” and assures that the president has “ensured every American gets the lowest prices on prescription medicine in the developed world.”
To illustrate its point, the site displays a side-by-side of EMD Serono’s fertility treatment Gonal-f at its previous price and its new MFN price compared to its price in Canada, which is listed as a “global reference.”
The NYT, however, put this claim to the test. When looking at worldwide drug prices for Novo Nordisk’s popular Wegovy, the TrumpRx price for the injection is in fact lower than Canada’s but remains higher than the cost in seven other countries including Germany, Britain and Japan, the news org found.
When comparing German prices specifically, the price discrepancy was the starkest for branded drugs that still have patent protection, such as Pfizer’s hormone treatment Ngenla. For two injection pens of that drug, the German public health system pays $2,723 less than a patient using TrumpRx discounts would, according to the report, which used data from German health insurance provider AOK.
That said, Pfizer’s Humira biosimilar Abrilada goes for $500 less on TrumpRx than it would in Germany, before discounts, according to the NYT.
Meanwhile, the investigation determined that patients without insurance are paying the lowest out-of-pocket prices for obesity drugs such as Eli Lilly’s Zepbound in Japan, with a four-week supply available for $155 versus $399 on TrumpRx.
In response, White House officials told the NYT that TrumpRx prices can still be cheaper than those of other countries even with a listed price difference when accounting for the economic conditions in each country, a point that Eli Lilly further endorsed.
“A dollar goes further in some countries than others,” Lilly spokesperson Misty Fuller told the news org. “A medicine isn’t necessarily cheaper abroad if wages and living costs are lower there.”
TrumpRx callouts
Trump’s broad claims of “huge savings,” as TrumpRx mentions, have been scrutinized by lawmakers as well. A late February report (PDF) from democrats on the U.S. House of Representatives’ Energy and Commerce Committee found that cheaper generic drugs are available for at least 15 drugs listed on the website and that drug savings platform GoodRx had already offered the same discount for at least seven medicines touted on the site.
“At best, the platform offers discount coupons that are readily available elsewhere. At worst, it appears to intentionally withhold information about more affordable generic alternatives and in some instances even charges consumers more than if they purchased the drug directly from the manufacturer,” ranking committee member Frank Pallone, D-N.J., commented, calling the website “not a serious effort to lower prescription drug prices.”
The lawmakers’ qualms are shared by the Center for American Progress, which found that, when accounting for GoodRx prices, lower-cost generics and existing manufacturer coupons, only one drug available on TrumpRx, EMD Serono’s Cetrotide, offers a price not previously accessible to cash-paying patients.
TrumpRx currently touts 54 drugs, available at the “lowest cash prices.” As the website does not sell the products directly, much of the medicine listed on the site can be purchased through the respective direct-to-patient platforms run by drugmakers, while others offer TrumpRx coupons that can be presented at the pharmacy.
The website uses GoodRx as a “core integration partner,” GoodRx said at the time of launch. GoodRx’s role is to offer drugmakers a “scalable way” to extend discounted cash prices to TrumpRx, allowing them to “rapidly operationalize most favored nation (MFN) and other policy-aligned pricing programs at national scale.”
Either way, the only patients who stand to benefit from any TrumpRx savings are those who self-pay at the pharmacy, leaving out the 85% of the U.S. population that has prescription drug insurance coverage, University of Washington health economics and policy professors Sean Sullivan, Ph.D., and Ryan Hansen, Ph.D., pointed out in a Stat opinion piece last month.
As the professors put it, the “real winners” at play are the pharmaceutical manufacturers themselves, which can “preserve their ability to maintain higher prices while appearing magnanimous through selective discounting.”