Take Ozempic as an example. For the average U.S. patient paying out of pocket, the blockbuster diabetes drug can cost anywhere from $349 to more than $1,000 a month. It costs $349 through TrumpRx. However, in several other wealthy countries, the next highest price is $190 a month, according to KFF, a nonpartisan research group. Enbrel is an even clearer example. A monthly supply of the rheumatoid arthritis drug costs $3,354 through TrumpRx, more than five times the average of $641 in the other countries where researchers found prices. However, some medications come out far ahead. Rydapt, a drug used to treat certain blood cancers, costs $2,909 for 56 capsules through TrumpRx, less than half the price of $5,901 for the same amount in France, the next cheapest country. Those disparities extend across the site, according to the KFF analysis. The report, which did not compare TrumpRx savings within the U.S., offers one of the first broad global comparisons of Trump’s claims about drug prices. The analysis looked at 32 brand-name drugs sold through TrumpRx that lacked generic or biosimilar equivalents. The researchers focused on those drugs because patients don’t have the option to switch to cheaper versions, meaning the discounts offered through TrumpRx could have a bigger impact on what they pay. The group compared prices with those in 11 other wealthy countries, including Canada, France, Germany, the Netherlands and the United Kingdom. Prices are current as of August 26. The results were divided almost equally. For 17 of the drugs, TrumpRx prices were lower than average prices abroad. By 15, they were taller. 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 upon by manufacturers who list their drugs on the TrumpRx website, the prices they offer, even at a discount, are still higher than prices in comparable countries.” Drug price discounts vary widely. The findings offer an early look at both the promise and 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 drugs are made by the same companies. The TrumpRx discounts, the White House says, arise from Trump’s “most favored nation” pricing deals, deals with drugmakers to charge Americans the lower prices they offer other countries in exchange for reduced tariffs. But discounts can vary widely, according to the analysis, and have not consistently produced the lower 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, that 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 related in any way to prices in other countries.” It is a markedly different approach from that taken by Trump’s predecessor, Joe Biden. Instead of using Medicare’s power to negotiate prices for a limited number of expensive drugs each year, TrumpRx relies heavily on voluntary agreements with individual drug makers to offer discounted prices directly to consumers. (The exact details of the deals remain largely confidential and the White House has declined to disclose them.) TrumpRx does not sell the medications directly. For many drugs, it sends consumers to manufacturer programs through which they can get coupons or discounted cash prices without insurance. This is not how most people get their prescription medications. 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 payment options have become increasingly popular as insurance has become more expensive. Money spent on TrumpRx does not count toward the patient’s co-pay or deductible. “These are very select products that the manufacturer is willing to offer a discount on,” Rome said. “Maybe they’re not the products that cause the most spending in the U.S. in some cases or they’re products that they were already offering confidential discounts on, but now they’re making those discounts more public.” The site now includes several cheaper generic medications. “But those generics and the low prices of those generics existed before the TrumpRx website,” Cubanski said. Direct price comparisons are difficult. KFF’s analysis does not capture all medications 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 prices in the U.S., lists 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. are not available in all of the countries KFF examined. That can make direct comparisons difficult. “One of the big differences is that the U.S. market has more products than international markets, so it’s noteworthy to the extent that we have options here in the United States rather than a one-size-fits-all treatment approach,” he said. International prices are also not always perfectly comparable, he said. The analysis was based on publicly available prices, which may not include confidential discounts negotiated between foreign governments and drug manufacturers. Ciaccia also noted that KFF’s 11 comparator countries do not exactly match the countries used in some of the administration’s international pricing programs. The White House did not immediately respond to a request for comment. Put the claim to the test Those limitations don’t change the basic comparison at the center 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 no clear pattern across the board for higher prices and no consistent pattern across the board for lower prices.” And the administration has made increasingly broad claims that it has accomplished just that. “Over the past year, my administration reached unprecedented deals with 26 of the world’s largest pharmaceutical companies, and the rest are coming very quickly, to provide their drugs to Americans at discounts of 60, 70, 80, even 90%,” Trump said last month. Health policy experts hope TrumpRx will eventually drive down prices in the United States, but they say it’s too early to tell. One concern, however, is that as more drugmakers close deals, they could also raise prices abroad, narrowing the gap without generating savings for Americans. “It’s not just that the price in the US can go down, but another way to have a lower price in the US is to have a higher international price, so it could be the case that if we do this comparison again in a year, we could find that the TrumpRx are lower than the international prices,” Cubanski said.
