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

The Trump administration pledged this week to considerably scale back the excessive costs Individuals generally pay for his or her prescribed drugs. It’s a promise that can undoubtedly come up quick.

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 properly increase drug costs for a lot of Individuals.

A significant plank of the chief order includes enhancing the Medicare Drug Pricing Negotiation Program: a Biden-era program that permits the federal government to straight negotiate the costs that Medicare can pay for among the costliest prescribed drugs available on the market. 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 includes 15 medicine and can conclude this yr, with reductions arriving in 2028.

Probably the most necessary 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 remedy Wegovy. Semaglutide-based medicine value upwards of $1,000 monthly with out insurance coverage, and lots of eligible sufferers can’t entry them as a result of excessive checklist costs and lack of protection. So if drug costs are actually lower, it might signify 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 drugs.

At present, Medicare can not straight cowl any weight reduction drugs, although it could possibly present protection to individuals taking Ozempic and related medicine for diabetes or sure obesity-related circumstances, corresponding to 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 Individuals on Medicare and Medicaid by 2026. Earlier this month, nevertheless, the Trump administration dropped this proposal. HHS chief Robert F. Kennedy stated final week that the administration is contemplating some kind of “framework” to develop 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 issues the so-called “tablet penalty.” Medicine aren’t eligible for the negotiation program till they’ve been available on the market for a sure period of time. For small molecule prescribed drugs, sometimes taken as drugs, this delay is at present seven years (truly 9 years earlier than the value lower comes into impact). However for biologics—extra complicated, 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 therapy” of those two drug sorts 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 making an attempt to handle this discrepancy have finished 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).

Based on a KFF evaluation launched on Wednesday, a four-year delay would have eliminated greater than half of the medicine included within the negotiation program up to now, 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 Individuals 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.

“Identical to his first time period, Trump is all bark and no chunk in the case of 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 greater costs for American seniors and households whereas the drug firms get a windfall to the tune of $10 billion.”

There are some nuggets of excellent concepts nestled within the government order, corresponding 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,” as an 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 greater prices and drug shortages, notably for generic drugs.

Nothing about Trump’s previous or latest monitor document 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.