By Elisabeth Rosenthal, Arthur Allen
Updated on: May 7, 2026 / 6:08 AM EDT
KFF Health News
Since his second term began, President Trump has announced, negotiated, or proposed a string of initiatives aimed at lowering drug costs. The moves respond to widespread public concern: roughly 60% of American adults say they worry about affording prescriptions, more than 80% call drug prices unreasonable, and Americans pay about three times what people in other countries pay for the same medicines.
Starting last July, Trump sent letters to 17 drugmakers asking them to voluntarily cut prices. He then met privately with more than a dozen pharmaceutical CEOs at the White House and in December said he had secured “most favored nation” pricing for Medicaid. The administration also unveiled TrumpRx — a website promising discounted cash prices for medicines — and pledged to speed approval of biosimilars, the nearly generic versions of costly biologic drugs, by reducing regulatory hurdles.
But key details are fuzzy, and the practical scope appears limited. Medicaid already pays steep discounts, many patients have other discount options through commercial programs, and company copay cards can make drugs affordable for insured patients. White House spokesperson Kush Desai did not respond to questions about TrumpRx.
Some people will benefit. Mark Cuban, who runs the Cost Plus Drug Co., praised TrumpRx discounts on branded fertility drugs and GLP-1 weight-loss medicines for uninsured shoppers. But experts say most of the White House deals are narrow publicity agreements. Aaron Kesselheim, a Harvard Medical School professor who studies drug pricing, called the announcements “one-off agreements made for publicity purposes” that are opaque and unenforceable.
Which medicines, if any, are covered by “most favored nation” pricing remains unclear — and many list prices rose despite the administration’s publicity. Data from 46brooklyn, which tracks brand-name drug prices, showed nearly 1,000 brand drugs increased in price in January 2026, after 2025 already saw a record number of list-price hikes. In the first week of 2026, Pfizer raised list prices on 71 drugs by an average of 5%, while lowering only one.
A more consequential, ongoing policy is the continuation of a Biden-era program: Medicare’s drug price negotiation. Discounts for the first group of 10 high-cost drugs — including insulins, blood thinners and medicines for inflammatory disorders — took effect Jan. 1. Some products saw cuts of well over 50%, and the savings helped Medicare cap annual out-of-pocket spending for Part D beneficiaries at $2,000 starting in 2025. Fifteen more high-cost drugs were negotiated in 2025 and take effect next year, and 15 additional drugs are slated for negotiation this year. Altogether, the 40 negotiated prices are expected to save Medicare more than $20 billion annually.
Drug industry lobbyists have tried to blunt the program’s reach; for instance, the One Big Beautiful Bill Act would exempt treatments for rare diseases from negotiations. Still, experts note that negotiating prices is historic for the U.S. and has not stopped pharmaceutical innovation, Kesselheim said.
But those negotiated savings mainly help Medicare enrollees. The Trump administration’s other initiatives — TrumpRx, the one-on-one company deals and promises to speed biosimilars — help only limited groups and often require knowing how to access the discounts.
The White House’s televised meetings with drug CEOs produced announced discounts, but consumer impact is mixed. After a meeting with Pfizer CEO Albert Bourla, Pfizer said it would discount more than 30 drugs through TrumpRx. Many of those offerings overlap with coupons already available through GoodRx and other discount programs. Pfizer said TrumpRx savings can reach as high as 85%, but many discounted branded drugs still compete with far cheaper generics.
Examples illustrate the limits. TrumpRx lists the branded cholesterol medicine Colestid at $127.91 (advertised as 50% off), while generic versions cost about $17 at Cost Plus. Hydrocortisone (Cortef) appears discounted on TrumpRx but sells for much less through other outlets. Some discounted drugs are old or require combination regimens that aren’t fully discounted — the HIV drug Viracept, listed at $607.20, is useful only alongside other treatments not on the list. Xeljanz, an arthritis drug, fell from $2,277 to $1,518 a month on TrumpRx — still unaffordable for many cash-paying patients.
TrumpRx has also listed Humira at $950 a dose (down from nearly $7,000) even though Humira lost U.S. patent protection in 2023 and biosimilars have been available; some biosimilars on TrumpRx are listed for as little as $207.60 a dose. The site launched Feb. 6 and largely features Pfizer’s roughly 30 discounted products out of about 85 on the portal.
A few notable, headline-making deals do provide substantial savings for certain cash-paying patients. TrumpRx lists three fertility drugs from EMD Serono (a Merck KGaA subsidiary), with Gonal‑F reduced from a $966 list price to $168 per IVF cycle with a coupon. That could save women thousands, but fertility drugs are only one portion of IVF’s $15,000–$25,000 cost, which typically requires multiple cycles. EMD Serono, in return for lowering prices, got tariffs lifted on its mostly overseas-made medications and won expedited FDA review for a fertility drug marketed in Europe.
Another high-profile deal cut Wegovy’s price to as low as $199 per monthly pen; Lilly’s Zepbound appears at $299. Insurers often cover GLP‑1 drugs only for diabetes, forcing many seeking weight loss to pay out of pocket. Pressure to lower U.S. prices is growing because generics and biosimilars are cheaper overseas — Canada may soon sell generic Wegovy for about $73 a month — but in the U.S. patent strategies can keep generics off the market for years. Patent experts say dozens of patents on GLP‑1s could keep generics out until 2039.
Speeding FDA approval of biosimilars may help, but the bigger barrier is legal and patent complexity. Often the delay is not regulatory but the time it takes to clear or challenge exclusive patent protections. For example, a generic for Otezla was FDA‑approved in 2021 but won’t reach the market until 2028 because of legal and market barriers. Proposals to require drugmakers to rebate Medicare if they charge the U.S. more than other countries for certain single-source drugs are still in rulemaking and would mainly benefit Medicare enrollees.
For uninsured or cash-paying consumers willing to shop, bargains exist — but they are scattered across different programs and sites. Finding the lowest price can require significant comparison shopping, coupon use, and knowledge of where generics or biosimilars are available. For many patients, especially those with insurance gaps or limited means, the Trump administration’s measures may provide some relief but do not represent a sweeping change in how drugs are priced in the U.S.
Data reporter Maia Rosenfeld contributed to this article.
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