Trump's Drug Price Initiatives: Mixed Results on Affordability for Americans

Since the start of his second term, President Donald Trump has rolled out a series of initiatives aimed at reining in the pharmaceutical industry’s pricing practices. These efforts come as no surprise, given that a recent KFF nationwide poll found that 60% of American adults are “worried about being able to afford prescription drug costs for themselves or their families.” More than 80% of Americans consider prescription drug prices “unreasonable,” and most support increased regulation to lower costs. Notably, Americans pay roughly three times as much as people in other countries for the same prescription drugs.

In July, Trump took direct action by sending letters to 17 drugmakers, demanding they voluntarily lower prices. Later, he claimed to have negotiated individually with more than a dozen pharmaceutical executives at the White House. By December, he announced that these companies had agreed to adopt “most favored nation” pricing for Medicaid, the government health coverage program for low-income Americans.

Additional measures included the launch of TrumpRx, a website where cash-paying patients could access discounted medicines, and a pledge to expedite the approval of biosimilars—generic versions of high-priced specialty drugs—by reducing FDA regulatory hurdles. However, the scope and impact of these initiatives remain unclear, as many details, including which specific drugs are covered, remain undisclosed.

The White House has not responded to inquiries about TrumpRx. Meanwhile, Medicaid already secures deep discounts on drugs, and other patients may find better deals through commercial discount programs, which offer a wider range of products, or through insurance plans and drug manufacturer copayment assistance programs.

Despite the fanfare, the share of Americans likely to benefit from these initiatives appears limited. As billionaire investor Mark Cuban noted, “If it makes a difference to any patient, it’s a win.” Cuban, who has his own mission to lower drug prices, highlighted discounted pricing on TrumpRx for branded fertility drugs and GLP-1 weight loss drugs for uninsured individuals or those with plans that exclude coverage. Cuban founded the Mark Cuban Cost Plus Drug Co. (Cost Plus Drugs) in 2022, selling drugs at lower prices by cutting out middlemen and purchasing directly from manufacturers. Most of the drugs offered by his company are generics.

Aaron Kesselheim, a professor of medicine at Harvard Medical School specializing in drug pricing, criticized Trump’s initiatives as “one-off agreements made for publicity purposes. They don’t change anything about the way drugs are priced.” He further described the agreements as “opaque and unenforceable,” citing a lack of clarity on which drugs would be subject to “most favored nation” pricing or how that pricing would be defined. The reality, he argued, is that not all drugs were included.

Data from 46brooklyn, a consulting firm and data project tracking brand-name drug prices, revealed that nearly 1,000 brand-name drugs saw price increases in January 2026. The year 2025 also marked the highest number of list price increases ever recorded. A spokesperson for 46brooklyn stated, “This is not a material change, it’s business as usual.”