Trump Is Promising to Decrease Drug Costs. Don’t Depend 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 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 Companies, 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 increase 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 available on the market. The primary spherical of negotiations occurred final 12 months and resulted in ten medication being discounted, although the value cuts received’t come into impact till 2026. The second spherical of negotiations includes 15 medication and can conclude this 12 months, with reductions arriving in 2028.

One of the crucial necessary medication on this second spherical is semaglutide, the energetic ingredient within the sort 2 diabetes medication Ozempic and Rybelsus, in addition to the weight problems treatment Wegovy. Semaglutide-based medication price upwards of $1,000 per thirty days with out insurance coverage, and plenty of eligible sufferers can’t entry them as a result of excessive checklist costs and lack of protection. So if drug costs are actually reduce, it will signify a real accomplishment. However once more, any such low cost wouldn’t arrive till 2028, in Trump’s (hopefully) final 12 months of the presidency. Within the meantime, his HHS has truly made it more durable for folks on Medicare to afford these drugs.

At the moment, Medicare can’t instantly cowl any weight reduction drugs, although it might probably present protection to folks taking Ozempic and related medication for diabetes or sure obesity-related circumstances, akin to coronary heart illness. The Biden administration proposed a rule final 12 months that will have ended this restriction and opened up protection to some 7 million People 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 type of “framework” to develop protection, although RFK Jr. himself has repeatedly questioned the worth of those medication up to now.

One other wrinkle in Trump’s plan to decrease drug costs considerations the so-called “capsule penalty.” Medication 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, usually taken as drugs, this delay is at the moment seven years (truly 9 years earlier than the value reduce comes into impact). However for biologics—extra advanced, expensive-to-produce medication 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 handle this discrepancy have performed so by extending the exclusivity interval of small molecule medication to match that of biologics (options from the Democrats have tried to decrease the interval for each).

In line with a KFF evaluation launched on Wednesday, a four-year delay would have eliminated greater than half of the medication included within the negotiation program thus far, together with semaglutide. Going ahead, an extended exclusivity interval for these medication would price the federal government loads of potential financial savings and finally harm 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 for certain 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 Massive 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 fine concepts nestled within the government order, akin to additional decreasing the price of insulin, attempting to make it simpler for states to import medication (an initiative that began throughout the first Trump time period), or accelerating the approval of generic medication. However even these proposals are undermined by actions the White Home has taken elsewhere.

The FDA has shed practically 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 medication imported into the U.S, which might result in greater prices and drug shortages, notably for generic drugs.

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