Trump Is Promising to Lower Drug Prices. Don’t Count on It

The Trump medication pledged this week to substantially trim the precocious prices Americans commonly wage for their medicine drugs. It’s a committedness that volition undoubtedly travel up short.

On Tuesday, President Donald Trump signed an enforcement bid laying retired the steps that the national government, via the Department of Health and Human Services, is readying to instrumentality to little cause prices. While immoderate of the proposals are sound, others are improbable to determination the needle. Trump and GOP lawmakers are besides preparing to, oregon already have, enacted different measures that could precise good rise cause prices for galore Americans.

A large plank of the enforcement bid involves improving the Medicare Drug Pricing Negotiation Program: a Biden-era programme that allows the authorities to straight negociate the prices that Medicare volition wage for immoderate of the costliest medicine drugs connected the market. The archetypal circular of negotiations occurred past twelvemonth and resulted successful 10 drugs being discounted, though the terms cuts won’t travel into effect until 2026. The 2nd circular of negotiations involves 15 drugs and volition reason this year, with discounts arriving successful 2028.

One of the astir important drugs successful this 2nd circular is semaglutide, the progressive constituent successful the benignant 2 diabetes drugs Ozempic and Rybelsus, arsenic good arsenic the obesity medicine Wegovy. Semaglutide-based drugs outgo upwards of $1,000 per period without insurance, and galore eligible patients can’t entree them owed to the precocious database prices and deficiency of coverage. So if cause prices are genuinely cut, it would correspond a genuine accomplishment. But again, immoderate specified discount wouldn’t get until 2028, successful Trump’s (hopefully) past twelvemonth of the presidency. In the meantime, his HHS has really made it harder for radical connected Medicare to spend these medications.

Currently, Medicare cannot straight screen immoderate value nonaccomplishment medications, though it tin supply sum to radical taking Ozempic and akin drugs for diabetes oregon definite obesity-related conditions, specified arsenic bosom disease. The Biden medication proposed a regularisation past twelvemonth that would person ended this regularisation and opened up sum to immoderate 7 cardinal Americans connected Medicare and Medicaid by 2026. Earlier this month, however, the Trump medication dropped this proposal. HHS main Robert F. Kennedy stated past week that the medication is considering immoderate benignant of “framework” to grow coverage, though RFK Jr. himself has repeatedly questioned the worth of these drugs successful the past.

Another wrinkle successful Trump’s program to little cause prices concerns the alleged “pill penalty.” Drugs are not eligible for the dialog programme until they’ve been connected the marketplace for a definite magnitude of time. For tiny molecule medicine drugs, typically taken arsenic pills, this hold is presently 7 years (actually 9 years earlier the terms chopped comes into effect). But for biologics—more complex, expensive-to-produce drugs typically taken by injection—the hold is 11 years (13 years really). In the enforcement order, Trump pledged to “align the treatment” of these 2 cause types successful the program.

But arsenic David Dayen astatine the Prospect and others person noted, the enforcement bid doesn’t really accidental that HHS volition shorten the hold of biologics eligible for the program. And existent pharma-backed GOP bills trying to code this discrepancy person done truthful by extending the exclusivity play of tiny molecule drugs to lucifer that of biologics (solutions from the Democrats person tried to little the play for both).

According to a KFF investigation released connected Wednesday, a four-year delay would person removed much than fractional of the drugs included successful the dialog programme to date, including semaglutide. Going forward, a longer exclusivity play for these drugs would outgo the authorities plentifulness of imaginable savings and yet wounded the wallets of galore Americans who trust connected them.

In a connection Wednesday, Senator Ron Wyden (D-Oregon), a subordinate of the Senate Finance Committee, argued that Trump’s enforcement bid is definite to lone weaken cause pricing reform.

“Just similar his archetypal term, Trump is each bark and nary wound erstwhile it comes to lowering the outgo of medicine drugs,” Wyden said. “This enforcement bid is rife with goodies that Big Pharma has been begging for, chiefly by weakening Medicare negotiation, which is going to mean higher prices for American seniors and families portion the cause companies get a windfall to the tune of $10 billion.”

There are immoderate nuggets of bully ideas nestled successful the enforcement order, specified arsenic further reducing the outgo of insulin, trying to marque it easier for states to import drugs (an inaugural that started during the archetypal Trump term), oregon accelerating the support of generic drugs. But adjacent these proposals are undermined by actions the White House has taken elsewhere.

The FDA has shed astir 20% of its workforce arsenic portion of a DOGE-orchestrated “restructuring,” for instance, which is already hampering its ability to process imaginable cause approvals. And the medication has begun to laic the groundwork needed to enforce tariffs connected drugs imported into the U.S, which could pb to higher costs and cause shortages, peculiarly for generic drugs.

Nothing astir Trump’s past oregon caller way grounds suggests that medicine drugs successful America are astir to get importantly cheaper. And if we’re genuinely unlucky, immoderate drugs could go adjacent much costly soon enough.