On September 30, 2025, President Donald Trump stood at the podium in the Oval Office, flanked by Pfizer CEO Albert Bourla, and made an announcement that could reshape how Americans buy their prescription drugs. Trump unveiled "TrumpRx," a government-run website designed to sell medications directly to consumers at steep discounts, with Pfizer as the first—and so far, only—major pharmaceutical partner. The move, he said, was part of a broader effort to end what he called "global price gouging at the expense of American families."
TrumpRx is slated to launch in early 2026, and while the fanfare was unmistakable, the details behind the scenes paint a more complicated picture. According to a 2024 RAND Corporation report cited by several outlets including The New York Post and CBS News, prescription drug prices in the United States are about 2.78 times higher than in 33 other high-income countries. The new initiative, Trump argues, is his answer to years of those disparities. "Today, I'm thrilled to announce that one of the world's largest pharmaceutical manufacturers and one of the best anywhere in the world, Pfizer, has agreed to offer countless prescription medications at major discounts in the United States, a result of the 'most favored nation' drug pricing order that we established earlier this year," Trump said, as reported by CBS News.
The nuts and bolts of the deal are significant: Pfizer will offer nearly all of its drugs to Medicaid at "most-favored-nation" prices. That means the company has pledged not to charge more in the U.S. for new drugs than it does in other wealthy countries. As part of the agreement, Pfizer will also invest a whopping $70 billion in U.S. manufacturing and research, and in return, it will enjoy a three-year exemption from new tariffs on imported medications—tariffs Trump threatened to impose on any company that didn't play ball on pricing.
But what does this mean for the average American? The answer, it turns out, depends on who you are and how you pay for your medicine. TrumpRx will allow customers to search for discounted medications online, but the deals are only available to those not using their health insurance. According to Axios and NPR, 92% of Americans had health insurance in 2023. For those millions, their insurance plans—especially if they cover the drug in question—will likely still offer lower prices than TrumpRx's cash deals. As The Wall Street Journal pointed out, most insured patients "probably pay less through their plans than they would at cash prices on TrumpRx."
For the uninsured and for those whose insurance doesn't cover a particular medication, TrumpRx could be a lifeline. Take, for example, the dermatitis ointment Eucrisa and the migraine nasal spray Zavzpret: on TrumpRx, Eucrisa will be available at 80% off its list price, and Zavzpret at 50% off. In another case, a 30-day supply of Xeljanz extended-release tablets, used to treat rheumatoid arthritis, costs $5,940 without insurance. TrumpRx could cut that price by 40%, bringing it down to $3,600 per month. However, as GoodRx notes, 96% of insurance plans already cover Xeljanz at a co-pay of just $60 to $83.
The deal's impact on Medicaid recipients—about 71 million Americans, or 21% of the population—is also limited. Medicaid already secures some of the lowest drug prices in the country, thanks to existing "best-price" protections. William Padula, a professor of pharmaceutical economics at the University of Southern California, told The New York Post, "In the Medicaid program, most drugs are already priced extremely low compared to national averages—the net prices are among the lowest in the country." Any additional savings, he said, will mostly benefit state agencies and the federal government, not individual enrollees, who already pay little to nothing out of pocket.
Pfizer CEO Albert Bourla was candid about what motivated his company's participation: Trump's threat of 100% tariffs on drugs manufactured outside the United States. "The president is absolutely right, tariff is the most powerful tool to motivate behaviors, Mr. President," Bourla said at the announcement, according to CBS News. As a result, Pfizer agreed to move its production of medicines used in America to U.S. soil and received a three-year grace period on tariffs as part of the deal.
The TrumpRx website itself is still a work in progress. As of early October, the site (TrumpRx.gov) isn't live, and officials are still ironing out exactly how it will function. According to CNN and Axios, customers will be able to search for medications on the site and then be redirected to direct-to-consumer channels from the manufacturer for purchase. The government will not sell or distribute the drugs directly.
The broader policy context is worth noting. Trump has pushed for a "most favored nation" pricing model since his first term, aiming to tie U.S. drug prices to those paid by other wealthy countries. While a previous executive order on the subject was blocked by federal courts in 2020, Trump revived the idea in May 2025, signing a new order directing the Department of Health and Human Services to set price targets for certain brand-name drugs. "By taking this bold step, we're ending the era of global price gouging at the expense of American families," Trump declared, as quoted by Axios.
Not everyone is convinced that TrumpRx is the prescription for what ails the U.S. health care system. Alan Sager, a professor at Boston University, told The New York Post, "American citizens [will] continue to pay through the nose to get vital drugs into our bodies. A few people will be better off—people who can afford to buy drugs that are not covered by their insurance through the website—because they’ll pay lower prices than they do now. But that’ll be a few people in every thousand."
Other experts echoed this skepticism, pointing out that TrumpRx, like other direct-to-consumer platforms such as Mark Cuban's Cost Plus Drugs, mainly helps those who fall through the cracks of the insurance system. "The direct-to-patient stuff is, in my view, a sideshow and branding opportunity for Trump. Most patients have drug coverage. … Very few are going to buy medications with cash, unless the drug is not a covered benefit, like weight loss or erectile dysfunction drugs," Sean Sullivan, a health economist at the University of Washington, told CBS News.
There are also concerns that TrumpRx doesn't address deeper systemic issues, such as the role of pharmacy benefit managers (PBMs) and the controversial 340B drug pricing program, both of which critics say contribute to high prices through markups and opaque pricing structures. Andrew Spiegel, CEO of the Global Colon Cancer Association, argued in The New York Post that real reform would require "reining in middlemen, reforming 340B, lowering tariffs that raise patient prices and adopting strong trade policies that ensure all countries pay their fair share—without stifling the investment in innovation that patients depend on."
Despite the unanswered questions about TrumpRx's reach and effectiveness, the announcement marks a new chapter in the ongoing debate over how to make prescription drugs affordable in America. As the administration finalizes the details and other pharmaceutical companies consider joining the program, millions are watching to see if TrumpRx will deliver on its promises—or if it will end up as just another experiment in the long struggle to rein in drug costs.
