TrumpRx isn’t doing much for drug prices. What would it take to change that?

TrumpRx isn't doing much for drug prices. What would it take to change that?

Americans are furious about drug prices. The Trump administration's answer? A new website.

NBC Universal A page on the TrumpRx site. (Scott Olson / Getty Images)

Butmore than a month after its launch, the site, TrumpRx.gov, remains small — offering discounts on just 54 prescription drugs. Many of those drugs already have cheaper generic versions or savings programs available elsewhere, and the discounts can't be used with insurance or count toward a deductible. Awareness of the site remains limited.

Whether TrumpRx actually lowers drug prices matters in ways that go beyond the success of the website itself. For President Donald Trump, it's tied toa broader push on health care costsas the midterms approach. But for many Americans,the issue taps into something deeper— years of frustration with a system they say feels stacked against them, where prices are hard to track and it's not always clear if they're getting a fair deal.

Health policy experts say that what the administration does next will determine whetherTrumpRx remains just another optionor evolves into something that actually helps make prescription drug costs easier to navigate.

"The idea isn't exactly new, but it does have sort of that Trump branding," said Audrey Kearney, a senior survey analyst at KFF, a nonpartisan health policy research group. "It's another option for consumers, and we'll kind of have to stay tuned to see if it'll make a real difference."

Kearneyco-authored a surveypublished last week by KFF that found that about a third of people who take prescription drugs said they had heard at least something about TrumpRx. Just 7% said they had visited the site to compare prices, rising to about 16% among people who take GLP-1 medications.

Even the White House acknowledges the website is still in its early days. A White House official declined to say how many people have visited the site or how many drugs will be added this month.

The official said IVF treatments andGLP-1 weight loss drugshave been among the most searched medications so far. The administration plans to add "a larger batch" of drugs to the platform soon, the official said, and hopes to work with Congress to codify some of the drug pricing deals into law as part of a broader health care plan.

"We don't see this as the end product," the official said. "The goal here is to pass the president's Great Healthcare Plan to codify these [Most Favored Nation] deals, so if people use insurance to buy these drugs, they can also access the savings."

There are no indications that Congress is taking up the legislation.

What could TrumpRx do differently?

In practice, TrumpRx works like existing discount sites such as GoodRx orMark Cuban Cost Plus Drug Co., letting people compare cash prices for medications, but with fewer tools and less flexibility — and no way to buy directly through the site.

"The fascinating thing about TrumpRx is that it's being touted as this new, innovative thing, when in fact, it's kind of coalescing things that already existed," said Antonio Ciaccia, CEO of 46brooklyn, a nonprofit group that tracks prescription drug prices.

The site relies on GoodRx's pricing data and technology to power many of its listings, Ciaccia said: The coupon cards are processed through GoodRx's network, using the same BIN and PCN numbers — the codes pharmacies use to process drug discounts at the pharmacy counter.

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What TrumpRx needs most is scale, said Geoffrey Joyce, director of health policy at the University of Southern California Schaeffer Center for Health Policy & Economics.

Of the initial batch of drugs on the site, roughly half have generic versions that are often much cheaper, Joyce said. Those generics are also widely available through other discount sites or at local pharmacies.

"In its current form, it's of limited use to uninsured consumers," Joyce said. "If they got rid of all the ones that had generic equivalents, you're looking at a site with 22 drugs. And it's basically a roundup of the usual suspects. It's some IVF, some GLP-1s. It's not a broad scope."

"Fifty-four drugs out of thousands, just proportionally speaking, it's a very small segment of the population," Ciaccia said.

Still, both Joyce and Ciaccia said TrumpRx has the potential — with the right investments — to go beyond existing discount sites.

Ciaccia said the platform could play a bigger role for people with private or job-based insurance, where patients don't always have access to the lowest-cost drug.

Pharmacy benefit managers, who decide which drugs go on insurers' formularies, often favor higher priced brand name drugs to secure larger rebates, sometimes excluding lower cost generics — a practice that can drive up costs for patients.

In those cases, patients could turn to a platform like TrumpRx to find a lower price brand name drug, even if their insurance favors that same medication at a higher cost.

"I think TrumpRx could be not a cure for the problems that exist today, but maybe it could supplant the system that we have," Ciaccia said. "If the discounts start to improve, there could be an option for employers who are already getting the short end of the stick on their benefit designs from PBMs."

Joyce also said the platform could become more useful by offering more transparency around drug prices, a focus of the Trump administration's health care agenda.

He pointed to Cost Plus Drug Co. as a starting point, where users can see a breakdown of a drug's price, including the ingredient cost, markup and shipping.

Currently, TrumpRx shows what people would pay compared with the drugmaker's list price. That comparison can be misleading, however, because insurance rarely pays that price and even people without insurance typically get discounts.

Improving transparency could include showing how prices vary by pharmacy or region, how discounts are negotiated and how insurance compares with cash prices.

"It's been the uninsured who have been getting screwed the most," Joyce said. "There are lower prices out there, and from an educational and informational perspective, I think that's valuable."

 

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