With questions already swirling about the real affordability impact of the government’s drug purchasing portal TrumpRx, the White House is updating the platform to address key gaps in the drugs on its list, although many caveats remain.
The expansion of TrumpRx.gov announced by President Donald Trump on Monday will add more than 600 generic drugs to the platform. The site allows patients to compare covered prices for specific drugs and also provides links to other direct-to-consumer purchasing platforms, such as online pharmacies and pharmacies operated by pharmaceutical companies.
When the website launched near the beginning of this year, TrumpRx initially included only select branded drugs that were eligible for price reductions under the Trump administration’s most-favored-nation policy. The policy seeks to broadly match high drug costs in the United States with the lowest prices paid in certain high-income comparison countries.
According to a White House fact sheet, the platform will separately list common generic drugs such as lisinopril, which lowers high blood pressure, and the ubiquitous diabetes drug metformin, as well as the cholesterol drug atorvastatin and the blood thinner clopidogrel.
The listing of counterfeit drugs on the government-run purchasing portal fills a huge gap left by TrumpRx’s debut earlier this year, with the FDA estimating that as many as 9 out of 10 prescriptions in the U.S. are now generic drugs.
As has been the case since the site’s launch, TrumpRx.gov does not sell generic drugs directly to patients, but instead allows patients to “compare the best cash prices available at local pharmacies,” as well as weigh delivery options through various private pharmacy programs. The White House noted that the website also integrates discounts offered through online drug channels such as Amazon Pharmacy, GoodRx, and Mark Cuban’s Cost Plus Drugs.
The update will include “some of the most popular and commonly used everyday medications,” according to the fact sheet, but TrumpRx will exclude controlled substances (such as stimulant-based ADHD medications), drugs with FDA-mandated Risk Evaluation and Mitigation Strategies (REMS), and drugs “not typically offered through direct-to-consumer channels.”
TrumpRx forms a key pillar of the president’s drug pricing and broader drug policy agenda, and in his most-favored-nation call to action last year, Trump called on 17 of the world’s largest drug companies to adopt direct-to-consumer sales channels, among other demands for lower prices.
Coupled with the cudgel of the second Trump administration’s drug import tariffs, the White House was able to extract pricing concessions and U.S. investment commitments from many of the industry’s most prominent drug companies, including Novo Nordisk, Eli Lilly, Gilead, Roche, and most recently, Regeneron.
Under these agreements, 17 major pharmaceutical companies have also committed to registering certain products at discounted prices through the TrumpRx portal, with Regeneron offering its cholesterol-lowering drug Praluent in that case.
Other branded drugs featured on the government’s site include Novo’s GLP-1 blockbuster Ozempic and Wigovy, Merck KGaA’s fertility drug EMD Serono, AstraZeneca’s inhaler, and Pfizer’s eczema ointment Eucrisa, to name just a few.
TrumpRx has been the subject of controversy even before its launch, drawing scrutiny from Democratic Sens. Dick Durbin of Illinois, Peter Welch of Vermont and Elizabeth Warren of Massachusetts, who warned the HHS Office of the Inspector General in January that the website could violate federal anti-kickback laws.
Since then, the site’s true impact on drug affordability for American patients has come into further question.
In March, reports in the New York Times and German news outlets Süddeutsche Zeitung, NDR and WDR found that drug prices in Germany remained lower than many drug prices listed on TrumpRx when compared side-by-side. At the time, the report also noted that although the TrumpRx price for Novo’s obesity drug WeGovy was lower than in Canada, it was still higher on the government site than in seven other countries, including Germany, the United Kingdom and Japan.
Reuters separately reported on Tuesday that through its own comparison of public prices, the fees listed on TrumpRx are often no lower than those paid in the United Kingdom.
