Can TrumpRx Really Cut Your Medication Costs? Here’s the Breakdown

The Trump administration has announced TrumpRX.gov, a federal direct-to-consumer (DTC) drug purchasing platform expected to feature Most Favored Nation (MFN) pricing on a limited set of brand-name medications.  

The administration hopes that TrumpRx.gov, a website offering reduced prices for prescription drugs, will go live early in 2026.  

The announcement was paired with the first pharmaceutical MFN deal with Pfizer.   

Other drug makers such as AstraZeneca also have deals-in-progress

New York-based Pfizer will charge most-favored-nation pricing to Medicaid and guarantee that pricing on newly launched drugs, Trump said. That involves matching the lowest price offered in other developed nations.

Pfizer has not agreed to reduce drug prices for employers, private insurance companies or Medicare.

What is Most Favored Nation Pricing (MFN)?

In the MFN plan, drug manufacturers agree to match the lowest price offered in other developed countries. 

Prescription drug prices in the US are roughly 2.78 times higher on average than in 33 other high-income countries, a 2024 report by the RAND Corporation found. 

While the US represents about 4% of the world’s population, it accounts for a disproportionately large share of global drug revenues, according to Alan Sager, a professor of heath law, policy and management at the Boston University School of Public Health.  

Trump and the MFN Model

Trump has long promised to slash drug prices, telling Time in 2016, “I’m going to bring down drug prices. I don’t like what has happened with drug prices.”

He signed an executive order in 2020 to establish a Most Favored Nations pricing model, including for Medicare Part B and Part D drugs.

But Trump’s policy never took effect — it was blocked by federal courts for not following proper rulemaking procedures. He reintroduced the MFN concept this year.

Will everyone get cheaper drugs under TrumpRx?

The short answer: Most people will not.

Some drug-pricing experts argue that that it will only help a sliver of the population.

How will it help consumers?

For those paying cash or without strong insurance drug benefits — TrumpRx offers some potential benefits. Here’s how:

Lower out-of-pocket cost: 

Some drugmakers have committed to steep discounts via TrumpRx. For example, the White House fact sheet says drugs like Wegovy and Ozempic will be available on TrumpRx at roughly US $350/month compared to much higher list prices. 

Improved transparency: 

Consumers can see cash prices directly, rather than relying solely on insurance benefit pricing, co-pays, deductibles, etc. 

Alternative for uncovered or under-insured patients: 

If you have a high deductible, limited drug coverage, or pay cash anyway, TrumpRx might provide a cheaper option

Important Exceptions

• Insurance coverage doesn’t apply so you may not get your plan’s negotiated price; your purchase may not count toward your deductible or out-of-pocket maximum, and your insurer won’t track utilization in the same way. 
• The price may not beat your existing benefit: For many insured consumers, the pharmacy benefit plan already negotiates very favorable pricing and co-payments — in those cases, the TrumpRx cash price may actually be higher than what they pay through their benefit. 
• Limited list of drugs initially: The program is starting with selected manufacturers and selected drugs. 

For example, a 30-day supply of Xeljanz extended-release tablets to treat rheumatoid arthritis can cost $5,940 without insurance, according to Drugs.com.

The new deal could slash that price by 40%, to about $3,600 a month.

There are no generic alternatives to Xeljanz, but GoodRx notes that 96% of insurance plans cover the most common version of Xeljanz at a co-pay of $60 to $83.

For consumers: What you should do now

• If you are uninsured, or your drug benefit is weak (high deductible, high co-pay) — keep an eye on TrumpRx as a possible option when it launches.
• If you are insured, compare the cash price you might pay via TrumpRx with your current insurance-negotiated cost: sometimes your benefit might still be better.