> At a Glance
> – 14 pharma companies agreed to tie U.S. prices to lower overseas rates
> – Breaks apply mainly to cash buyers on TrumpRx and to Medicaid
> – Why it matters: Most insured Americans will keep paying insurance copays, not the new, lower cash prices
President Trump’s latest push to slash drug costs is making headlines, yet early details suggest the deals will trim bills for only a narrow slice of patients.
What’s Been Agreed
Under agreements reached since Sept. 30, 14 manufacturers will adopt a “most-favored-nation” model that matches U.S. prices to those paid in other wealthy countries. In exchange, the White House says the firms will receive tariff relief.
- Who benefits first: uninsured or cash-paying customers using the new TrumpRx portal
- Secondary impact: state Medicaid programs, though enrollees already face minimal copays
- Who’s left out: people with private insurance or Medicare, which together cover the vast majority of Americans
The administration has named 8 drugs set for cuts:
| Drug | Maker | List Price | New Cash Price |
|---|---|---|---|
| Epclusa (hepatitis C) | Gilead | $24,920 | $2,425 |
| Wegovy (weight loss) | Novo Nordisk | ~$500/mo | $350 → $250* |
| Zepbound (weight loss) | Eli Lilly | ~$500/mo | $350 → $250* |
| Januvia (diabetes) | Merck | Not stated | Tied to global rate |
| Plavix (blood thinner) | Sanofi | Not stated | Tied to global rate |
| Repatha (cholesterol) | Amgen | Not stated | Tied to global rate |
| Xofluza (flu) | Genentech | Not stated | Tied to global rate |
| Mayzent (multiple sclerosis) | Novartis | Not stated | Tied to global rate |
*Prices fall to $250 within two years
Experts See Limited Reach
Because the agreements exclude most insurance plans, Juliette Cubanski of KFF notes:
> “Most people with coverage will continue to be better off using their insurance rather than purchasing through the TrumpRx portal.”
Several experts say the selection lacks the nation’s costliest therapies. Art Caplan, NYU Grossman School of Medicine, points out that Plavix and Epclusa already have cheaper generics, while Xofluza has a narrow 48-hour usage window that may not suit an online-only model.
Richard Frank, Brookings Institution, warns the publicized reductions could simply be discounts firms already planned:
> “Until we see a real contract committing companies to price changes, it’s hard to say anything is actually happening.”
Unknowns Loom
- No comprehensive drug list has been released
- No timetable beyond “early this year” for TrumpRx and “coming months” for Medicaid
- No estimate of total consumer savings
Compounding the uncertainty, manufacturers have raised prices on more than 350 brands in 2025, averaging 4%, according to 3 Axis Advisors data cited by Reuters.
Key Takeaways
- Breaks are real but narrow: Big cash discounts apply mainly to the 26 million uninsured and high-deductible patients
- Insured majority unaffected: Medicare and private-plan copays won’t change under these deals
- Savings details missing: Without public contracts, experts can’t verify how much money, if any, will actually be saved
Even with a 50% cut, a $250 monthly tab remains steep for many households, and Medicaid already pays the nation’s lowest drug prices. Until full documentation emerges, the splashy announcements may deliver more symbolism than systemic relief.
