What is TrumpRx and how does it work?
TrumpRx.gov is a direct-to-consumer (DTC) website operated by the federal government where patients can pay cash prices for certain prescription drugs. The website is part of a broader Trump administration initiative focused on bringing American drug prices closer to prices paid in other developed countries. This is being referred to as most-favored-nation (MFN) drug pricing.
While the government will not purchase and sell drugs directly, the TrumpRx website will redirect patients to DTC websites of drug manufacturers that have entered agreements with TrumpRx. The website has already been launched, and patients can begin purchasing drugs at TrumpRx prices by early 2026.
Who is negotiating and why?
Major drug manufacturers are voluntarily negotiating with the Trump administration to avoid tariffs on their branded products. In late September, the administration announced 100% tariffs on branded or patented imported drugs that were set to take effect on October 1. The tariffs were ultimately delayed while the administration negotiated with manufacturers willing to voluntarily lower drug prices.
As part of these agreements, the manufacturers committed to make certain drugs available at MFN prices via TrumpRx, offer MFN pricing to Medicaid, launch new drugs at MFN prices and invest heavily in domestic drug manufacturing. In return, the manufacturers receive a three-year grace period from the brand tariffs. The specific terms of these pricing agreements have been deemed confidential and have not been publicly disclosed.
The following manufacturers have entered into agreements to offer certain drugs on TrumpRx at discounted prices:
- Pfizer
- Amgen
- AstraZeneca
- Eli Lilly
- Novo Nordisk
- EMD Sorono
How does this impact employer-sponsored health coverage?
At this time, TrumpRx pricing is only available to cash-paying patients who are not using their health benefit plans. Some manufacturers’ press releases have confirmed that the agreements do NOT apply to commercial market pricing. Thus, the patients most likely to benefit from TrumpRx are uninsured patients and patients seeking access to drugs not covered by their plan. Any patient spend through the website will not count towards a patient’s deductible or maximum out-of-pocket.
DTC programs are not a new concept, and several manufacturers have launched DTC websites over the last few years. However, these options typically only include a narrow subset of drugs and may not result in a lower net cost. For most patients, the drugs will still be cheapest when accessed through the benefit plan.
Still, the public availability of these discounted prices will serve as new benchmarks that plan sponsors expect in the commercial market. Some manufacturers have committed to offering lower prices to the commercial market and decreasing the list prices of newly launched drugs, but the impact of these commitments will depend heavily on the specific scope of these agreements, which have yet to be released.
Looking ahead
These are not finalized policies, and updates continue to emerge as additional manufacturers negotiate with the administration. Tariffs may come back into play for manufacturers unable to reach an agreement. While the full impact of these announcements is uncertain, Employers Health is committed to keeping clients informed along the way.
