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

The Trump administration pledged this week to considerably cut back the excessive costs People generally pay for his or her prescribed drugs. 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 a number of the proposals are sound, others are unlikely to maneuver the needle. Trump and GOP lawmakers are additionally getting 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 chief order includes bettering the Medicare Drug Pricing Negotiation Program: a Biden-era program that permits the federal government to instantly negotiate the costs that Medicare pays for a number of the costliest prescribed drugs in the marketplace. The primary spherical of negotiations occurred final yr and resulted in ten medicine being discounted, although the worth cuts received’t come into impact till 2026. The second spherical of negotiations includes 15 medicine and can conclude this yr, with reductions arriving in 2028.

One of the essential medicine on this second spherical is semaglutide, the energetic ingredient within the kind 2 diabetes medicine Ozempic and Rybelsus, in addition to the weight problems treatment Wegovy. Semaglutide-based medicine value upwards of $1,000 monthly 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 lower, 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 truly made it tougher for individuals on Medicare to afford these medicines.

At present, Medicare can not instantly cowl any weight reduction medicines, although it will probably present protection to individuals taking Ozempic and comparable medicine for diabetes or sure obesity-related situations, reminiscent of coronary heart illness. The Biden administration proposed a rule final yr that will 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 up to now.

One other wrinkle in Trump’s plan to decrease drug costs considerations the so-called “capsule penalty.” Medication should not eligible for the negotiation program till they’ve been in the marketplace for a sure period of time. For small molecule prescribed drugs, usually taken as capsules, this delay is presently seven years (truly 9 years earlier than the worth lower comes into impact). However for biologics—extra advanced, expensive-to-produce medicine usually taken by injection—the delay is 11 years (13 years actually). Within the government order, Trump pledged to “align the therapy” of those two drug varieties in this system.

However as David Dayen on the Prospect and others have famous, the chief order doesn’t truly say that HHS will shorten the delay of biologics eligible for this system. And present pharma-backed GOP payments attempting to deal with this discrepancy have executed 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 accordance 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 so far, together with semaglutide. Going ahead, an extended exclusivity interval for these medicine would value the federal government loads of potential financial savings and finally 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 chunk relating to decreasing the price of prescribed drugs,” Wyden mentioned. “This government order is rife with goodies that Large Pharma has been begging for, primarily by weakening Medicare negotiation, which goes to imply increased 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, reminiscent of additional lowering the price of insulin, attempting to make it simpler for states to import medicine (an initiative that began through 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 increased prices and drug shortages, notably for generic drugs.

Nothing about Trump’s previous or latest observe file means that prescribed drugs in America are about to get considerably cheaper. And if we’re actually unfortunate, some medicine might change into much more costly quickly sufficient.