Take Ozempic. For the average patient in the U.S. paying out of pocket, the blockbuster diabetes drug can cost $349 to more than $1,000 a month. It’s $349 through TrumpRx. Yet in several other wealthy countries, the next-highest price is $190 a month, according to KFF, a nonpartisan research group.
Enbrel is an even starker example. A monthly supply of the rheumatoid arthritis drug costs $3,354 through TrumpRx, more than five times the $641 average in the other countries where researchers found prices.
Some drugs, however, come out well ahead. Rydapt, a drug used to treat certain blood cancers, costs $2,909 for 56 capsules through TrumpRx — less than half the $5,901 price for the same amount in France, the next-cheapest country.
Those disparities run throughout the site, according to the KFF analysis. The report, which didn’t compare TrumpRx savings within the U.S., offers one of the first broad worldwide comparisons of Trump’s drug pricing claims.
The analysis looked at 32 brand-name drugs sold through TrumpRx that lacked generic or biosimilar equivalents. Researchers focused on those drugs because patients don’t have the option of switching to cheaper versions, meaning the discounts offered through TrumpRx could have a greater impact on what they pay.
The group compared the prices with those in 11 other wealthy countries, including Canada, France, Germany, the Netherlands and the United Kingdom. The prices are current as of Aug. 26.
The results were almost evenly split. For 17 of the drugs, the TrumpRx prices were lower than the average prices abroad. For 15, they were higher. But Trump has promised Americans the lowest prices in the world. By that measure, the results were less favorable: Only five were actually the lowest-priced, while 13 were the highest-priced.
“It’s kind of a mixed bag,” said Juliette Cubanski, deputy director of the Medicare policy program at KFF, who co-authored the report. “Even with the reductions that may have been agreed to by manufacturers who are listing their drugs on the TrumpRx website, the prices that they’re offering, even at a discount, still continue to be higher than prices in comparable countries.”
Drug price discounts vary widely
The findings offer an early look at both the promise and the limits of Trump’s approach to lowering drug prices.
Americans routinely pay more for prescription drugs than patients in other wealthy countries, even when the medications are made by the same companies. The TrumpRx discounts, the White House says, stem from Trump’s “most favored nation” pricing deals, agreements with drugmakers to charge Americans the lower prices they offer other countries in exchange for tariff relief. But the discounts can vary widely, the analysis found, and they haven’t consistently produced the lowest prices Trump promised.
“I’m not surprised by these findings,” said Dr. Benjamin Rome, a primary care physician and health policy researcher at Harvard Medical School. “Any of us who have been following drug prices realized, as soon as TrumpRx was launched, it was a limited number of drugs and it was clear that the prices that were there were not always going to be linked or in any way related to what the prices are in other countries.”
It’s a markedly different approach from the one taken by Trump’s predecessor Joe Biden.
Rather than use Medicare’s power to negotiate prices for a limited number of costly drugs each year, TrumpRx relies largely on voluntary agreements with individual drugmakers to offer discounted prices directly to consumers. (The exact details of the agreements remain largely confidential, and the White House has declined to disclose them.)
TrumpRx doesn’t sell the drugs directly. For many drugs, it sends consumers to manufacturer programs through which they can obtain coupons or discounted cash prices without insurance.
That’s not how most people get their prescription drugs. About 9 in 10 Americans have some form of health insurance, meaning many pay for medications through private insurance, Medicare or Medicaid — although discounted cash-pay options have become increasingly popular as insurance has gotten more expensive. The money spent on TrumpRx doesn’t count toward a patient’s copay or deductible.
“They’re highly selected products where the manufacturer is willing to offer a discount,” Rome said. “Maybe they’re not the products causing the highest spending in the U.S. in some cases or are products where they were already offering confidential discounts, but now they’re making those discounts more public.”
The site now includes several cheaper, generic medications. “But those generics and the low prices for those generics pre-existed the TrumpRx website,” Cubanski said.
Direct price comparisons are difficult
The KFF analysis doesn’t capture every drug available through TrumpRx, and there are limits to how much can be concluded from it.
Antonio Ciaccia, CEO of 46brooklyn Research, a group that tracks drug pricing in the U.S., counts about 80 brand-name drugs currently on TrumpRx, while KFF was able to compare prices for 32.
Part of the challenge, Ciaccia said, is that some drugs sold in the U.S. aren’t available in all of the countries KFF examined. That can make direct comparisons difficult.
“One of the big differences is the U.S. market does have more products in it than international markets, so that is noteworthy to the extent we have options here in the U.S. rather than a one-size-fits-all treatment approach,” he said.
International prices aren’t always perfectly comparable, either, he said. The analysis relied on publicly available prices, which may not include confidential discounts negotiated between foreign governments and drugmakers.
Ciaccia also noted that KFF’s 11 comparison countries don’t exactly match the countries used in some of the administration’s international pricing programs.
The White House didn’t immediately respond to a request for comment.
Put the claim to the test
Those limitations don’t change the basic comparison at the heart of Trump’s claim: whether the prices offered to Americans match or beat those available abroad.
“We wanted to put that claim to the test with this analysis,” Cubanski said. “There is not a clear pattern across the board for higher prices or no consistent pattern across the board for lower prices.”
And the administration has increasingly made broader claims that it has accomplished just that.
“Over the past year, my administration has reached unprecedented agreements with 26 of the world’s largest pharmaceutical companies, and the rest are all coming in very rapidly, to provide their drugs to Americans at discounts of 60, 70, 80 and even 90% discount,” Trump said last month.
Health policy experts hope TrumpRx will ultimately bring U.S. prices down, but they say it’s too soon to know. A concern, however, is that as more drugmakers strike deals, they could also raise prices abroad, narrowing the gap without delivering Americans savings.
“It’s not just that the price in the U.S. might come down, but another way of having a lower U.S. price is by having a higher international price, and so it could be the case that if we do this comparison again in a year, we might find that TrumpRx are lower than international prices,” Cubanski said.
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