TrumpRx and the Politics of Affordability

Big promises, narrow solutions, and a familiar affordability playbook.

“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.”

That is the claim at the top of the TrumpRx website, presented in large, sweeping type. It suggests that the federal government has finally used its full authority to rein in prescription drug prices for every American.

TrumpRx does address a real problem. Prescription drugs are expensive, and many Americans struggle to afford them. But a close look at TrumpRx reveals a very narrowly focused program aimed at lowering drug costs for a specific group of Americans, not a structural reform of drug pricing.

Understanding TrumpRx

TrumpRx is a government-branded discount portal, not a pharmacy. It allows users to search a limited list of medications priced to align with the lowest prices paid in other developed countries. Consumers can access these prices in one of two ways: by downloading a coupon to use at participating pharmacies, or by clicking through to a manufacturer-run purchase channel.

At launch, TrumpRx covers roughly 40 to 45 drugs from five manufacturers. It includes some GLP-1 and fertility medications—drugs not always covered by insurance. TrumpRx, like other programs already available (GoodRx, Amazon Pharmacy, Costco, and Cost Plus Drugs), can be helpful for people without insurance or with very high deductibles, but there are several important limitations to understand.

More than half the drugs included in TrumpRx at launch are also available in generic form. The generic version is likely to be cheaper than the discounted price offered through TrumpRx.

At launch, CVS is the only confirmed participating pharmacy. Each pharmacy chooses which discount programs and coupons it will accept. Users must confirm that both the pharmacy and the specific drug they need are covered.

Because TrumpRx operates outside of insurance, spending through the program does not count toward insurance deductibles or out-of-pocket maximums.

Beyond participating pharmacies, TrumpRx also allows for purchasing directly from pharmaceutical companies, often referred to as direct-to-consumer (DTC) programs. Large pharmaceutical companies, including those whose products appear on TrumpRx, have historically been slower to embrace DTC. But the Trump family is ready to step in, for a fee. Donald Trump Jr. is an investor in BlinkRx, a company designed to provide the digital infrastructure needed to support DTC drug purchasing.

To be clear: TrumpRx will help a small number of people, primarily those who are uninsured, underinsured, or facing high deductibles, by giving them access to a limited number of prescription drugs through voluntary agreements. That will not, as promised, ensure that “every American gets the lowest prices on prescription medications in the developed world.”

Also important to note is that Trump’s other policies are making the purchase of prescription drugs more difficult. By cutting Medicaid and ending Affordable Care Act subsidies, the Trump Administration has pushed millions of families into situations where affording necessary medications becomes an ongoing crisis.

A More Impactful Approach

By law, the Veterans Administration has the authority to use its purchasing power to control drug prices through caps on what manufacturers can charge the program and to encourage the use of effective, lower-cost drugs first, while still allowing access to other medications when needed.

As a result, the VA routinely pays substantially less for the same drugs. A more comprehensive solution to high drug prices is to expand the VA’s drug management program across the federal government.

But even fully leveraging government purchasing power would not solve the entire problem. Millions of Americans obtain prescription drugs outside federal programs, and addressing affordability for them requires confronting prices in the broader market.

The most straightforward approach is to set or constrain prices. While this may sound radical, it is something the U.S. government already does in other sectors where consumers cannot easily walk away, such as electricity, water, and natural gas. And globally, negotiated or regulated drug pricing is the norm. The United States is the exception.

Learn More About Trump’s Affordability Agenda

Affordability will be a central issue in the upcoming midterm elections. Trump has rolled out a series of good-sounding programs that, like TrumpRx, offer limited relief while avoiding deeper reforms. Check my other posts about this:

The Wrong Way to Fix the Childcare Crises:

https://www.murmurimpact.com/p/the-wrong-way-to-fix-the-childcare

Endnotes

1. TrumpRx launch and promotional claims https://www.trumprx.gov

2. Veterans Administration drug pricing model
   U.S. Department of Veterans Affairs, statutory ceiling prices and formulary management under the Federal Supply Schedule and VA National Formulary.
   https://www.va.gov/formularyadvisor/

3. Direct-to-consumer pharmaceutical sales and telehealth
   Health Affairs, analysis of the growth of direct-to-consumer drug models and telehealth prescribing.
   https://www.healthaffairs.org/do/10.1377/forefront.20220303.674189

4. BlinkRx and direct-to-consumer infrastructure
   Public reporting on BlinkRx’s business model as a digital pharmacy platform supporting DTC drug purchasing, including investor disclosures. https://www.blinkhealth.com

5. Medicaid and ACA coverage changes
   Kaiser Family Foundation (KFF), analysis of Medicaid eligibility changes, ACA subsidy expiration, and impacts on uninsured rates and out-of-pocket costs.
   https://www.kff.org/health-reform/