Trump Is Promising to Decrease Drug Costs. Don’t Rely on It

The Trump administration pledged this week to considerably scale back the excessive costs People generally pay for his or her pharmaceuticals. It’s a promise that may undoubtedly come up brief.

On Tuesday, President Donald Trump signed an government order laying out the steps that the federal authorities, by way of the Division of Well being and Human Providers, is planning to take to decrease drug costs. Whereas among the proposals are sound, others are unlikely to maneuver the needle. Trump and GOP lawmakers are additionally making ready to, or have already got, enacted different measures that would very effectively elevate drug costs for a lot of People.

A significant plank of the manager order entails bettering the Medicare Drug Pricing Negotiation Program: a Biden-era program that enables the federal government to straight negotiate the costs that Medicare can pay for among the costliest pharmaceuticals in the marketplace. The primary spherical of negotiations occurred final yr and resulted in ten medicine being discounted, although the value cuts received’t come into impact till 2026. The second spherical of negotiations entails 15 medicine and can conclude this yr, with reductions arriving in 2028.

One of the vital vital medicine on this second spherical is semaglutide, the energetic ingredient within the sort 2 diabetes medicine Ozempic and Rybelsus, in addition to the weight problems medicine Wegovy. Semaglutide-based medicine value upwards of $1,000 per 30 days with out insurance coverage, and plenty of eligible sufferers can’t entry them because of the excessive listing costs and lack of protection. So if drug costs are actually minimize, it could symbolize a real accomplishment. However once more, any such low cost wouldn’t arrive till 2028, in Trump’s (hopefully) final yr of the presidency. Within the meantime, his HHS has really made it more durable for folks on Medicare to afford these medicines.

Presently, Medicare can’t straight cowl any weight reduction medicines, although it may possibly present protection to folks taking Ozempic and comparable medicine for diabetes or sure obesity-related situations, comparable to coronary heart illness. The Biden administration proposed a rule final yr that may have ended this restriction and opened up protection to some 7 million People on Medicare and Medicaid by 2026. Earlier this month, nonetheless, the Trump administration dropped this proposal. HHS chief Robert F. Kennedy stated final week that the administration is contemplating some type of “framework” to increase protection, although RFK Jr. himself has repeatedly questioned the worth of those medicine previously.

One other wrinkle in Trump’s plan to decrease drug costs issues the so-called “capsule penalty.” Medication aren’t eligible for the negotiation program till they’ve been in the marketplace for a sure period of time. For small molecule pharmaceuticals, sometimes taken as tablets, this delay is presently seven years (really 9 years earlier than the value minimize comes into impact). However for biologics—extra advanced, expensive-to-produce medicine sometimes taken by injection—the delay is 11 years (13 years actually). Within the government order, Trump pledged to “align the remedy” of those two drug sorts in this system.

However as David Dayen on the Prospect and others have famous, the manager order doesn’t really say that HHS will shorten the delay of biologics eligible for this system. And present pharma-backed GOP payments making an attempt to handle this discrepancy have accomplished so by extending the exclusivity interval of small molecule medicine to match that of biologics (options from the Democrats have tried to decrease the interval for each).

In keeping with a KFF evaluation launched on Wednesday, a four-year delay would have eliminated greater than half of the medicine included within the negotiation program thus far, together with semaglutide. Going ahead, an extended exclusivity interval for these medicine would value the federal government loads of potential financial savings and in the end damage the wallets of many People who depend on them.

In an announcement Wednesday, Senator Ron Wyden (D-Oregon), a member of the Senate Finance Committee, argued that Trump’s government order is definite to solely weaken drug pricing reform.

“Similar to his first time period, Trump is all bark and no chew in relation to decreasing the price of pharmaceuticals,” Wyden mentioned. “This government order is rife with goodies that Massive Pharma has been begging for, primarily by weakening Medicare negotiation, which goes to imply larger costs for American seniors and households whereas the drug corporations get a windfall to the tune of $10 billion.”

There are some nuggets of fine concepts nestled within the government order, comparable to additional decreasing the price of insulin, making an attempt to make it simpler for states to import medicine (an initiative that began throughout the first Trump time period), or accelerating the approval of generic medicine. However even these proposals are undermined by actions the White Home has taken elsewhere.

The FDA has shed almost 20% of its workforce as a part of a DOGE-orchestrated “restructuring,” for example, which is already hampering its ability to course of potential drug approvals. And the administration has begun to lay the groundwork wanted to impose tariffs on medicine imported into the U.S, which might result in larger prices and drug shortages, notably for generic drugs.

Nothing about Trump’s previous or latest monitor document means that pharmaceuticals in America are about to get considerably cheaper. And if we’re actually unfortunate, some medicine might develop into much more costly quickly sufficient.