When the Trump administration rolled out TrumpRx as a drug buying site with great fanfare, officials said it was a game-changer. But is it?
The verdict is in: There’s more hype than actual savings.
In many cases, would-be buyers are disappointed right out of the gate: Anyone using Medicaid, Medicare, TriCare, Veterans Administration care or any other government-linked health insurance plan is unable to use TrumpRx. Also anything you spend via TrumpRx will not apply to your deductible. In many cases, the site sends you to existing manufacturer coupon savings pages.
The site currently has about 50 medications, so a lot of people won’t find anything of use. It’s not clear why these medications were chosen, or what benefits the manufacturers get from such an arrangement. For most people with insurance, the insurance price will be lower than the TrumpRx price. Insurance will not be billed at all.
So who benefits? Uninsured people and those who are not on government-related insurance, a tiny slice of the U.S. population.
You do not actually buy from TrumpRx — the site directs you elsewhere to buy. If you do qualify, there may be some opportunities — and there are many, many cases where the promises are simply unfulfilled.
Despite that, the site blares: “Thanks to President Trump, the days of Big Pharma price-gouging are over. Leveraging the full weight and power of the United States of America, the President has ensured every American gets the lowest prices on prescription medications in the developed world.”
Weight-loss drugs
So let’s get into it.
Try the GLP-1 weight-loss drug Wegovy: The site says it’s taking the price from $1,349.02 to $199 — but it clearly says it’s just $199 for the first two months, then the price jumps to $349 a month. At the online site Ro, it’s $149 a month. The discount drug coupon site GoodRx advertises the same $149 a month.
For the Airsupra albuterol-budesonide inhaler, TrumpRx sends you to an Astra-Zeneca website for an existing patient assistance program. (Again, these programs do not apply for those on government-oriented health insurance.) Another inhaler, Glycopyrrolate/formoterol from AstraZeneca, is listed at $51, down from an original price of $458.05, and this offer too links you to AstraZeneca, which will “determine your eligibility and guides you through available support options” — in other words, use the existing Astra-Zeneca patient assistance program.
In truth, we have learned that some people are not aware of the patient asssitance programs, so this is a help for some — but it’s not new by any means.
For a number of other prescriptions, the would-be purchaser is given a coupon from GoodRx, an established platform for collecting various kinds of drug discounts and delivering them via coupon. These are not identified as GoodRx coupons, but GoodRx has said it is involved in TrumpRx. One thing that’s confusing is that there are many, many more coupons on GoodRx than there are GoodRx coupons on TrumpRx. So it’s not clear that the average would-be buyer knows that GoodRx exists, with many more good buys.
It’s also true that many pharmacies won’t accept GoodRx coupons — is the same true of these TrumpRx coupons? It’s hard to know.
TrumpRx also seems to ignore Mark Cuban Cost Plus Drugs, a direct-to-consumer site selling mostly generics by mail order. A KFF analysis found: “About half (22) of the drugs on TrumpRx have generic equivalents available in the U.S., at least three-quarters (17) of which are less expensive via GoodRx discounts or direct purchase from Cost Plus Drugs than the TrumpRx coupon price for the brand-name version. Five brand-name drugs on TrumpRx are less expensive on TrumpRx than their generic equivalents on the other two websites.”
Same as Lilly site
The health economist Jane Sarasohn-Kahn wrote on LinkedIn that there is no difference in the consumer-facing price, self-pay, for Zepbound on TrumpRx as compared with LillyDirect — > $399 for 5 mg (4 vials).
“I was keen to check the TrumpRx website at launch today as the hashtag#GLP1s have garnered a plethora of self-pay patients keen to lose weight on the patented branded product,” she wrote. “I’ll be watching to see if prices lower on TrumpRx platform but for now, it’s just another channel for Lilly Direct with the same price Eli Lilly and Company already offers direct-to-patient — no additional negotiation from the The White House in this case of a highly-demanded product and hashtag#selfcare condition. The price is still out-of-reach for many patients. …
“The good: Cash-pay, DTC options can bypass PBMs and help deflate the gross-to-net bubble by lowering list prices. The bad: Several brand-name drugs are still priced far above readily available generic equivalents, raising costs for patients who don’t shop around. The ugly: Despite the spin, this does not consistently “lower costs on the most popular drugs.””
“TrumpRx is a side show,” Sean D. Sullivan, a health economist at the University of Washington, said to the New York Times. “I consider it not a real, serious effort in service to lowering prescription drug prices for Americans.”
Fertility meds
The offerings for fertility meduications seem to possibly offer some savings, but the picture is mixed.
One commenter on Reddit wrote: “I work for an infertility clinic and we just had a meeting with the manufacturers. You can either go to trumprx OR https://www.fertilityinstantsavings.com/home.html.
One commenter wrote: “Pretty confused because I paid $58 per injection for Ovidrel OOP through Freedom Pharmacy just a few months ago, but Trumprx is touting an $84 price.” Another wrote that discounts are available only at certain pharmacies with the TrumpRx fertility medication coupons.
On Facebook, several commenters said that prices for Gonal-F were better on TrumpRx, while others noted that these prices matched the ones for overseas pharmacies, which is a common workaround for those trying to conceive. Gonal-F, Cetrotide and Ovidrel seem to be the only IVF medications for now.
A LinkedIn post by Casey Langwith, a healthcare advisor, specified the three IVF medications and how they are sold: “Specialty mail-order with limited pharmacy network (3 drugs) EMD Serono’s fertility drugs (Gonal-f, Cetrotide, Ovidrel) … Claims are processed by PDMI, a small independent claims adjudicator based in Ohio. Dispensing is handled through a network of specialty fertility pharmacies — including Evernorth’s Freedom Fertility and VFP, CVS Caremark, Alto Pharmacy, and several established independents like Mandell’s. The network mirrors EMD Serono’s existing specialty pharmacy relationships, not a new TrumpRx-specific channel.”
Along with the patient assistance programs and the GoodRx coupon channels, these three channels form the backbone of TrumpRx — for now, at least, though the administration has promised it will expand the program.
Comparative savings
In another post on LinkedIn, she reproduced a chart from Stat with comparative prices. How much more can you save by turning away from TrumpRx and going elsewhere? This is Stat’s research, not ours, but we know them and feel confident about their research. Very impressive research and reporting.
Nowhere is there a mention of Mark Cuban Cost Plus Drugs, which offers some of these medications — the generic ones, that is — for pennies. The big gap in thinking here is that 90 percent of prescriptions filled in the U.S. every year are generics, and TrumpRx has no signposts to this really important source of prescription savings.
Summing up, the KFF analysis said: “While TrumpRx offers the hope of cheaper medications, whether it will make a significant difference for most people will depend largely on the breadth of prescription drugs available on the website, the cost of the specific medication, state law or pharmacy policy regarding generic drugs, the plan design of the patient’s private insurance plan, if insured, and, particularly for the uninsured, whether there is a less expensive generic version of the drug. This puts a lot more onus on patients, particularly those with private coverage, to understand the many dynamics at play in determining the best option for them. In some cases, TrumpRx advertisement for these discounted brand-name prescription drugs could have the potential to mislead patients into paying more out-of-pocket than they would if they used their insurance and/or purchased a generic alternative.”
What you can do
Interested in knowing if you can save via TrumpRx?
Go to TrumpRx and look for your medications.
Compare prices in every possible way: Using your insurance (if applicable), using GoodRx alone separate from TrumpRx, using cash prices. For some, the Amazon pharmacy may be a good deal. With generics, often Mark Cuban Cost Plus wins. (It’s cash only, by mail order, almost all generics.)
A note about GoodRx: Think of going to GoodRx independently and comparing TrumpRx with the independent GoodRX price where you are. We have seen GoodRx prices vary widely, even from month to month or week to week for the same medication in the same Zip code. We think this is because GoodRx is cutting deals behind the scenes with pharmacies and keeping up-to-date pricing that gives advantage to GoodRx and the pharmacy and the manufacturer — while making it seem like the consumer is their only audience and the biggest winner. Do they have a long-term contract with TrumpRx? Maybe. Like everywhere else in U.S. healthcare, do your own research. Do not blindly accept what you’re being told.
Can you use your insurance? “For now, the website says its prices are for people paying with their own money, rather than going through insurance. But TrumpRx directs people to an Eli Lilly site where they can use their insurance to get Zepbound, the popular weight-loss drug,” The New York Times reported.
Can’t find your medication on TrumpRx? You’re not alone. There really are very few medications on the site. Do your own research: Check out Mark Cuban Cost Plus Drugs, the GoodRx site, and also Google “patient assistance programs (name of medication).”
Some people buy overseas, so you might compare prices there. Technically the Food and Drug Administration considers this illegal. But it is widely known that if you travel to Hong Kong (or Mexico or Canada) and come back with medications, or order from a reputable online Canadian pharmacy, you are probably going to be safe from prosecution. But it’s a different question whether the medication is manufactured to U.S. standards. Note that there’s a lot of arm-waving about dangerous foreign generic drugs, but the truth is that a lot of Big Pharma drug manufacturing takes place overseas and across borders, and has for years. (Was your drug made overseas? More information here.)
Who benefits from TrumpRx? “Americans with insurance typically have coverage for most of the drugs on the site, often with low out-of-pocket costs. For example, if you have an insurance co-pay of $25 a month for Farxiga, a drug often used for diabetes, you would be paying too much at the TrumpRx price of $182,” The New York Times reported.” ‘In the vast majority of cases, it’ll be cheaper to go through your insurance,’ said Ameet Sarpatwari, who studies pharmaceutical policy at Harvard Medical School.”
