President Donald Trump announced the latest addition to his personal branding empire this week: TrumpRx, a government website that claims it will offer deeply discounted drugs to many Americans. News of the website’s forthcoming launch was accompanied by an announcement from Pfizer that it would voluntarily reduce the prices it charges the Medicaid program.
It all sounds like genuinely good news: a new website offering low-cost drugs and new discounts for an insurance program that covers millions of low-income Americans. And it looks great on the press release: “President Trump is delivering on promises for American patients that the political establishment did not believe were possible.”
But what he actually delivered was a splashy announcement — and, at least so far, little else. The actions heavily promoted by the Trump administration this week are unlikely to meaningfully affect the prices paid by most Americans for their prescription drugs.
"It's really easy to do something that sounds like it's going to save people money and lower profits for pharma and save taxpayers money. It's much harder to actually do those things,” said Stacie Dusetzina, who studies drug pricing at Vanderbilt University. She called it simultaneously “a great press release” and “a splashy announcement without a lot of substance.”
The problem is in the details or, rather, the lack thereof. Let’s get into it.
TrumpRx doesn’t bring anything new to the prescription drug market
The specifics on TrumpRx are still lacking: As Axios wrote on Wednesday, the new site isn’t expected to launch until next year. In the meantime, White House officials are still finalizing how it will look and function.
The gist is supposed to be: You go on TrumpRx.gov (once it’s live) and you can find prescriptions available at a discounted price if you’re paying cash. It’s pretty simple in concept, but there are a few problems.
First, there are fewer potential customers than you might think. For the 90-plus percent of Americans who have health insurance, you are probably already getting a lower price than you’d find on TrumpRx for these drugs through your insurance plan. Even if the price is similar or slightly lower on TrumpRx, you are better off using your insurance anyway, so that what you are paying counts toward your deductible. The sooner you reach your deductible, the less money you’ll have to pay out of pocket for any kind of medical care.
If you’re an uninsured person who does want to pay cash for drugs, it’s still not clear how much TrumpRx will help you. The drugs could still cost hundreds of dollars per month, even at the new discounted rates, and services similar to this — websites where you pay cash for medications directly — already exist. Billionaire Mark Cuban’s Cost Plus Drugs and GoodRx are well-known examples. Dusetzina told me she had found drugs on GoodRx that were available right now at lower prices than what the Trump White House previewed in its big announcement. Take Xeljanz, for example: The White House said the arthritis drug would be available at a 40 percent discount on TrumpRx, or about $3,600 for a monthly supply, but Dusetzina said she found it on GoodRx for about $3,000 (and so could I).
So, TrumpRx may be another option, and there might be some good prices there, but you’re still going to want to shop around.
Pfizer’s deal to cut Medicaid prices leaves a lot of questions unanswered
The other big piece of news this week was that the Trump administration and Pfizer had reached a deal to ensure that the company charges the Medicaid program, which covers almost 80 million low-income Americans, prices that are no higher than what it charges other nations.
Again, it sounds good. But look under the hood, and the impact is more dubious. For starters, this deal is both confidential and voluntary, according to Pfizer’s own announcement of the deal, so we do not actually know much at all about these new discounts.
“Confidential agreements make it very difficult to assess who is actually benefitting, if anyone, or how they are benefitting,” said Rachel Sachs, a health law professor at Washington University in St. Louis.
Plus, Medicaid patients already have little to no cost-sharing when they fill a prescription at the pharmacy. So they are unlikely to feel the difference when they actually buy their medicine. There is still some potential upside, though: If the discounts do lead to more savings for state Medicaid budgets, it could, in theory, allow the states to improve coverage for prescription drugs or other medical services.
However, it’s not actually clear — and we can’t know because the deal is confidential — whether benchmarking Medicaid’s drug prices to other nations will lead to any savings. Dusetzina told me it’s possible that, because Medicaid already receives federally required discounts on the medications it purchases, those prices are already close to or even lower than the international prices that Trump is fixated on. (Other experts have said the same.)
As Sachs noted to me, the Pfizer stock price actually rose on the news — which would suggest Wall Street doesn’t see the new plan as a blow to the company’s business prospects.
For more on TrumpRx, including some better ideas to cut drug prices, you can read Dylan's full story on the Vox site here.
