Many of President Donald Trump’s campaign promises to lower drug prices in the United States are said to have been fulfilled through the recently launched direct-to-consumer platform TrumpRx, which is built on most-favored-nation pricing, which benchmarks domestic prices against international prices.
But a new report in the New York Times says there may be some caveats to TrumpRx’s claims to offer “the world’s lowest prices on prescription drugs.” A study conducted by the NYT and German news agencies Süddeutsche Zeitung, NDR and WDR found that drug prices in Germany are lower than many drug prices listed on TrumpRx when compared directly.
Last May, the president issued an executive order mandating most-favored-nation drug pricing, decrying “price gouging” that forces American patients to pay “almost three times as much” for the same drugs as patients in other developed countries. At the time, President Trump claimed in a post on Truth Social that the order would reduce prescription drug prices by 30% to 80%.
Letters were then sent to 17 of the world’s largest pharmaceutical companies demanding that they bring U.S. drug prices in line with drug prices in other countries and sell their products through DTC platforms. Pfizer was the first to sign the agreement, and other companies in the industry followed suit.
In February, President Trump put MFN price trading into action with the launch of TrumpRx, a drug purchasing platform.
“The days of Big Pharma’s price gouging are over,” the website said, assuring the president that “we have ensured that all Americans can afford the lowest prices on their prescription drugs in the developed world.”
To illustrate the point, the site displays the old and new MFN prices for EMD Serono’s fertility drug Gonal F side-by-side, compared to the Canadian price, which is listed as a “world standard.”
However, the NYT verified this claim. In looking at global drug prices for Novo Nordisk’s popular WeGoBe, the news organization found that while the price of the Trump Rx shot is actually lower than in Canada, it is still higher than prices in seven other countries, including Germany, the United Kingdom and Japan.
In particular, when comparing prices in Germany, the price difference was most noticeable for brand-name drugs that are protected by patents, such as Pfizer’s hormone therapy Ngenra. For two injection pens of the drug, Germany’s public health system would pay $2,723 less than patients who took advantage of the TrumpRx discount, according to the report, which used data from German health insurance company AOK.
However, according to the New York Times, Pfizer’s Humira biosimilar Abrilada costs $500 less on TrumpRx than in Germany before discounts.
Meanwhile, the study found that uninsured patients in Japan have the lowest out-of-pocket prices for obesity drugs such as Eli Lilly’s Zepbound, where they can get a four-week supply for $155, compared to $399 for TrumpRx.
In response, White House officials told the New York Times that given each country’s economic situation, TrumpRx’s price could still be lower than prices in other countries, even with the difference in listed prices, a point further supported by Eli Lilly.
“The dollar is worth more in some countries than in others,” Lilly spokeswoman Misty Fuller said. “Just because wages and living costs are lower overseas doesn’t necessarily mean that medicines are cheaper.”
TrumpRx Callout
As TrumpRx notes, President Trump’s widespread claims about his “huge savings” have also come under scrutiny from lawmakers. A late February report (PDF) by Democratic members of the U.S. House Energy and Commerce Committee found that cheaper generic drugs were available for at least 15 drugs listed on its website, and drug-savings platform GoodRx was already offering similar discounts on at least seven drugs advertised on its site.
“At best, this platform simply offers discount coupons that are readily available elsewhere. At worst, it appears to be intentionally withholding information about more affordable generic alternatives, and in some cases even charging consumers more than they would if they had purchased the drug directly from the manufacturer,” said Frank Pallone, D.N.J., a member of the rankings committee, who said the website “is not a serious effort to lower prescription drug prices.”
The lawmakers’ concerns were shared by the Center for American Progress, which found that given GoodRx’s prices, low-cost generic drugs and existing manufacturer coupons, only one drug, EMD Serono’s Cetrotide, is available on TrumpRx, offering a price previously inaccessible to cash-paying patients.
TrumpRx currently advertises 54 drugs available at the “lowest cash prices.” Because this website does not sell products directly, many of the medications listed on the site are available for purchase through their respective patient-direct sales platforms operated by pharmaceutical companies, although some sites offer TrumpRx coupons that can be presented at pharmacies.
The website uses GoodRx as a “core integration partner,” GoodRx said at the launch. GoodRx’s role is to provide drug companies with 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 on a national scale.”
In any case, the only patients who would benefit from savings from TrumpRx, other than the 85% of the U.S. population with prescription drug insurance, are those who pay out-of-pocket at the pharmacy, University of Washington health economics and policy professors Dr. Sean Sullivan and Dr. Ryan Hansen pointed out in an opinion piece in Statistic last month.
In the professors’ words, the “real winners” are the drug manufacturers themselves, who can “maintain the ability to maintain higher prices while appearing generous through selective discounting.”
