Photo by: Jeff Trierweiler
President Trump released his “Trump RX plan” this week. What does it do? How does it work? And what else could be done to lower the cost of prescription drugs?
To start, Trump’s RX plan cannot be used with an insurance plan; the consumer must pay 100% of the cost, not a co-pay. Second, the plan only works if you pay cash for the drug. Third, the plan covers a limited number of medicines. Fourth, in many cases, there are better options than Trump RX.
Trump is using the buying power of the United States to lower drug prices. This is something progressives like Senator Bernie Sanders have long demanded.
“I agree with President Trump: It is an outrage that the American people pay, by far, the highest prices in the world for prescription drugs. It is beyond unacceptable that we pay, in some cases, ten times more for the same exact prescription drugs than people in other major countries. But let’s be clear: The problem is not that the price of prescription drugs is too low in Europe and Canada. The problem is that the extraordinarily greedy pharmaceutical industry made over $100 billion in profits last year by ripping off the American people,” Sanders said in response to Trump’s plan.
And while President Trump refuses to acknowledge it, his plan is building on President Biden’s work. The Trump administration’s Center for Medicare and Medicaid Services (CMS) webpage states: “In August 2022, President Biden signed the Inflation Reduction Act of 2022 (P.L. 117-169) into law. The law makes improvements to Medicare by expanding benefits, lowering drug costs, and improving the sustainability of the Medicare program for generations to come.”
For the first time, Medicare was allowed to negotiate drug prices for every Medicare beneficiary enrolled in a drug plan. The Biden administration started with 10 drugs and was working to expand the list when President Trump was elected. For example, the CMS under Biden negotiated to lower the price of the blood thinner Xarelto by 62% — from $6,204 to $2,634. Under the Biden plan, individuals can also use their insurance, and many patients only have to pay the co-pay.
Trump’s plan expands on Biden’s work. It is not limited to Medicare or Medicaid recipients. Trump has used the nation’s buying power to help all Americans get lower prices. But in many cases, the price President Trump negotiated isn’t the lowest. A comparison of drug prices helps understand the point. Of the 10 drugs the Biden administration was able to lower through negotiation, Trump was only able to lower one for everyone — Farxiga.
President Trump was able to lower it by 52% to $181.59. President Biden did better — lowering it to $178.50 — and all a patient was responsible for was the co-pay because the Biden plan allowed consumers to use their health insurance. Under the Trump plan, because the patient is not allowed to use their insurance, they would be responsible for the entire amount.
Unfortunately, not many people will be able to access Trump RX. Eighty-five percent of Americans with health insurance will not be able to use their coverage with Trump RX.
And there aren’t always savings compared to other plans. The Trump plan relies upon the same practices that companies like SingleCare and GoodRx use. And in many cases, Singlecare is less expensive. For example, for Pristiq on Trump Rx is $210 for 30 days. With SingleCare, the lowest price is $22.87 for the same amount and number of pills.
For some other medicines, the Trump RX rate is lower. Some drug prices the Trump administration negotiated were already available to people paying cash.
The limited savings available through Trump RX will not make up for what Trump eliminated in subsidies for the Affordable Care Act. 85,000 Pennsylvanians have been priced out of the market, losing health insurance and prescription plans. Even with Trump Rx, most will have to pay far more than their co-pay. Pennie, the Affordable Care Act marketplace, states that ACA “enrollees were faced with an average price increase of 102% to remain in their plan for 2026, creating significant affordability challenges for many Pennsylvanians. Enrollees who dropped the plan were primarily older and living in rural areas, as well as those with incomes just above Medicaid eligibility.”
The 11% of Americans experiencing poverty who do not qualify for Medicaid are unlikely to get help from TrumpRX, SingleCare, or any other program that negotiates a lower price. No matter the discount, the prices remain out of reach. Programs like Pennsylvania’s PACE and PACE Net and New Jersey’s PAAD offer greater savings.
It is the first few days of the Trump RX rollout. If one can overlook the impropriety of an elected official naming a program after himself, there is some promise. There is now an acceptance by both Democratic and Republican elected officials that the government can and should negotiate for lower drug prices.
As of today, President Trump’s health care plan has done more harm than good by forcing millions to drop health insurance, driving up prices, and offering limited savings on drug costs. We can all hope that will change in the months to come, but to expect it is to forget all the other statements President Trump has made, that have not, and will not come true.
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