Donald Trump has unveiled a series of drug pricing deals that he claims will significantly reduce the cost of prescription medicines for Americans. However, the reality is more nuanced, as the agreements come with notable limitations.
Voluntary Agreements Under the 'Most Favored Nation' Initiative
The White House recently announced its 17th voluntary agreement with a pharmaceutical company as part of Trump's so-called 'most favored nation' (MFN) initiative. This policy aims to align US drug prices more closely with the lower prices paid in countries like Britain, Canada, and Germany, where governments negotiate directly with drug manufacturers.
Trump has long argued that Americans are being 'ripped off' by paying the highest medicine prices globally, while other nations pay less for the same treatments. His solution involves pressuring major pharmaceutical firms into signing deals that cut prices on selected drugs, offer direct-to-patient discounts, lower costs for Medicaid programs, or cap patient payments for blockbuster medicines.
Deals Already Struck
Agreements have been reached covering cholesterol-lowering statins taken by millions of Americans and blockbuster weight-loss injections that many patients currently pay up to $1,000 per month for. The newest deal, signed this week with Regeneron, reduces the listed price of the cholesterol-lowering drug Praluent from $537 to $225 via the TrumpRx online portal. Regeneron also pledged $27 billion in US investment and committed to providing a rare deafness gene therapy free to eligible patients.
Other notable deals include Pfizer cutting prices on major medicines like Lipitor, Lyrica, and Paxlovid by 50 to 85 percent. Eli Lilly capped the monthly cost of its weight-loss injection Zepbound at $50 for some Medicare patients and offered lower prices through its LillyDirect platform for self-pay patients. Novo Nordisk agreed to pilot lower prices for semaglutide-based drugs for some Medicare and Medicaid patients. Bristol Myers Squibb will provide the blood thinner Eliquis free to Medicaid patients and discount other medicines for cash-paying customers.
Critics Point to Major Limits
Despite these announcements, critics argue that the scheme has substantial shortcomings. Many discounts apply only to uninsured patients or those whose insurance does not cover a specific drug. Others relate to state Medicaid programs rather than ordinary privately insured families. Furthermore, only a relatively small number of medicines have been listed on the TrumpRx website, meaning the scheme currently covers only a fraction of the thousands of drugs used by Americans.
Nevertheless, the agreements do include lower prices for some high-profile medicines used for heart disease, diabetes, obesity, arthritis, asthma, and cancer. Trump has described the deals as historic and claimed some prices have fallen by as much as 600 percent, a figure widely disputed by economists and lawmakers.
Political Significance
Drug prices remain one of the most politically potent issues in America. Millions of voters complain that medicines cost far more in the US than overseas, particularly insulin, inhalers, cancer drugs, and newer weight-loss injections. With healthcare costs rising, taking on 'Big Pharma' allows Trump to present himself as fighting for consumers while also encouraging companies to manufacture more drugs in America. Several agreements include promises to invest billions in US factories and research.
Full List of Drugs Available at a Discount
- Praluent (alirocumab) – High cholesterol – $537 to $225
- Lipitor (atorvastatin) – High cholesterol – Part of Pfizer cuts of 50% to 85%
- Lyrica (pregabalin) – Nerve pain – Part of Pfizer cuts of 50% to 85%
- Paxlovid (nirmatrelvir/ritonavir) – Covid – Part of Pfizer cuts of 50% to 85%
- Gonal-f (follitropin alfa) – Fertility treatment – Part of IVF bundle at 84% off
- Ovidrel (choriogonadotropin alfa) – Fertility treatment – Part of IVF bundle at 84% off
- Cetrotide (cetrorelix) – Fertility treatment – Part of IVF bundle at 84% off
- Zepbound (tirzepatide) – Weight loss – $50 monthly cap for some Medicare patients
- Wegovy (semaglutide) – Weight loss – No exact price disclosed
- Ozempic (semaglutide) – Type 2 diabetes – No exact price disclosed
- Aimovig (erenumab) – Migraine – $299 monthly
- Amjevita (adalimumab-atto) – Autoimmune disease – $299 monthly
- Eliquis (apixaban) – Blood thinner – Free for Medicaid patients
- Epclusa (sofosbuvir/velpatasvir) – Hepatitis C – No exact price disclosed
- Januvia (sitagliptin) – Diabetes – Up to 70% off
- Janumet (sitagliptin/metformin) – Diabetes – Up to 70% off
- Humira (adalimumab) – Arthritis/autoimmune disease – No exact price disclosed
- Synthroid (levothyroxine) – Thyroid disease – No exact price disclosed
Amgen agreed to offer migraine injection Aimovig and autoimmune drug Amjevita for a flat $299 per month, a substantial reduction on normal sticker prices. AbbVie included arthritis blockbuster Humira and thyroid drug Synthroid in the programme, while pledging $100 billion in US manufacturing and research spending. AstraZeneca committed to selling chronic disease medicines directly to patients at around 80 percent off list prices, and GSK said it would lower costs on inhalers and respiratory drugs for asthma and COPD. Merck also joined the scheme, offering diabetes drugs Januvia and Janumet at discounts of up to 70 percent.
