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As Costs Soar for Millions, TrumpRx Scam Offers Savings on 'Exactly One' Drug: Analysis
"For the 22 million Americans whose premiums have doubled, and the millions more who stand to lose coverage, a $56 discount on a fertility drug is not 'immediate relief.'"
Mar 18, 2026
US President Donald Trump launched TrumpRx last month with a bold promise to the American public: "dramatically lower prices on dozens of common, high-cost, brand-name prescription drugs."
But an analysis released Tuesday by the Center for American Progress (CAP) found that of the 54 medications listed on TrumpRx.gov as of March 16, "exactly one" drug—the fertility medication Cetrotide—is available at a "genuinely new lower price" not available elsewhere.
The CAP analysis emphasized that TrumpRx—touted by the administration as a path to "immediate relief" for consumers in the country with the highest drug prices in the world—is extremely limited by design, listing just 0.2% of all federally approved medications in the US.
Additionally, the terms that site users must accept before gaining access to coupons for discounted prices state that beneficiaries cannot be "enrolled in insurance from any government, state, or federally funded medical or prescription benefit programs."
Patients also must have a prescription to use TrumpRx for discounts. "According to a KFF analysis," CAP noted, "nearly half (46.6%) of uninsured adults ages 18 to 64 reported not seeing a doctor or other health professional in 2023."
"Applied to the estimated 27.9 million adults without insurance in 2026, this means that approximately 13 million Americans will never reach the most basic prerequisite for using TrumpRx: a visit with a clinician who can write a prescription," CAP added.
The think tank's analysis found that 17 of the drugs on TrumpRx—or over 30% of them—have generic equivalents that are available at a lower cost elsewhere, something that the Trump-branded platform doesn't tell users.
"Among the remaining 37 drugs without lower-cost generics, GoodRx offers comparable or lower prices for 20," CAP found. "That leaves 17 drugs where TrumpRx appears to offer a better deal. But in 16 of those cases, the same or lower prices were already available through manufacturer coupons and patient assistance programs. After accounting for all existing discount channels, just one drug—Cetrotide, a fertility medication—offers a price that was not previously available to cash-paying patients."
Neda Ashtari, associate director of health policy at CAP and author of the new analysis, said in a statement that the Trump administration is "undermining the most powerful tool for lowering patients’ costs at the pharmacy counter—health insurance coverage—and replacing it with a government-branded coupon book."
“For the 22 million Americans whose premiums have doubled, and the millions more who stand to lose coverage," due to Trump and the GOP's refusal to extend enhanced Affordable Care Act subsidies, "a $56 discount on a fertility drug is not 'immediate relief,'" Ashtari added.
CAP's analysis was released a day before The New York Times and the German news organizations Süddeutsche Zeitung, NDR, and WDR debunked Trump's claim last month to have delivered the lowest drug prices "in the entire world"—which would be news to the 1 in 3 US adults who say they've rationed medications, skipped meals, or made other painful tradeoffs over the past year to afford healthcare expenses.
"The drugs listed on TrumpRx can cost American patients up to hundreds or thousands of dollars, while a patient walking into a German pharmacy pays next to nothing," the Times observed on Wednesday. "The German health system foots the bill, and records show that, more often than not, it pays less than what the Trump administration negotiated for Americans."
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Congressional Report Warns TrumpRx May Lead 'Families to Pay More to Big Pharma'
"The president should work with Democrats and Republicans to actually lower prescription drug costs for families," said Sen. Maggie Hassan, "rather than helping Big Pharma line its pockets."
Feb 13, 2026
Democratic members of the congressional Joint Economic Committee on Friday released a report warning that US families could end up spending thousands of dollars more on prescription drugs because of a website recently unveiled by President Donald Trump.
Launched last week with pharmaceutical companies, TrumpRx.gov is marketed as an aggregator to help patients save on prescription drugs by using manufacturer coupons or buying directly from manufacturers.
However, as the new report highlights, "many of the brand-name drugs listed on TrumpRx have significantly cheaper generic alternatives, which are excluded from TrumpRx. This means that TrumpRx steers families to pay more to Big Pharma when they could be getting the same medication at a much lower price."
"No matter what the president says, the bottom line is that TrumpRx directs families to buy expensive brand-name drugs when generic versions are available elsewhere at a fraction of the cost."
The report provides a chart comparing TrumpRx and generic prices, both for one prescription fill and the full annual cost. It also notes the difference. In some cases, the president's option is $10-50 more a year. However, there are also examples in which families could save hundreds or thousands of dollars with generic drugs.
For example, Colestid, a medication that lowers cholesterol, would cost $2,771.21 a year through TrumpRx, compared with $856.70 for the generic option, a difference of $1,914.51. The antidepressant Pristiq is $2,401.20 on the president's website, versus just $320.88 for the generic, a potential yearly savings of $2,080.32.
The biggest difference featured in the document is for Tikosyn, which helps patients maintain a normal heart rhythm. The TrumpRx annual cost is $4,032, whereas the generic is only $192.68, a difference of $3,839.32.
The report also stresses how extra costs from the president's site could stack up for households in which multiple people need medication:
- For example, if in one family a parent gets treatment for high cholesterol and their child gets treated for seizures, over the course of 2026 this family would pay $2,142 more if they use TrumpRx versus generic drug alternatives.
- For another family where one adult gets treatment for depression while the other receives treatment for menopause symptoms, over the course of 2026 this family would pay $2,493 more if they use TrumpRx versus generic drug alternatives.
"No matter what the president says, the bottom line is that TrumpRx directs families to buy expensive brand-name drugs when generic versions are available elsewhere at a fraction of the cost," said Sen. Maggie Hassan (D-NH), ranking member of the Joint Economic Committee and the Senate Finance Subcommittee on Health Care.
"The president should work with Democrats and Republicans to actually lower prescription drug costs for families," Hassan argued, "rather than helping Big Pharma line its pockets."
While the Trump White House responded defensively to the Democratic report, with spokesperson Kush Desai claiming to MS NOW that "product listings on TrumpRx.gov are in no way an endorsement for use of any prescription drug over another" and accusing Democrats of "resorting to idiotic or simply ignorant lines of attack instead of simply giving the president credit where it's due," the panel members aren't alone is highlighting such cost differences.
The added cost for US families also isn't lawmakers' only concern about TrumpRx. Last month, shortly before the site's launch, Democratic Sens. Dick Durbin (Ill.) Elizabeth Warren (Mass.), and Peter Welch (Vt.) sent a letter to the US Department of Health and Human Services Office of Inspector General raising concerns about the new direct-to-consumer (DTC) platform.
"There appear to be possible conflicts of interest involved in the potential relationship between TrumpRx and an online dispensing company, BlinkRx, on whose board the president's son, Donald Trump Jr., has sat since February 2025," they wrote. "Moreover, legitimate concerns about inappropriate prescribing, conflicts of interest, and inadequate care have been raised about the exact types of DTC platforms to which TrumpRx would route patients."
The trio also expressed alarm about high prices, noting that "pharmaceutical manufacturers who will reportedly be participating in TrumpRx have spent billions of dollars in combined advertising expenses for drugs sold on existing DTC platforms."
"The pharmaceutical industry's outrageous DTC advertisements fuel demand for specific medications, which balloon healthcare expenses," the senators wrote. "We are concerned that DTC advertising, including in relation to TrumpRx, will steer customers to prescriptions that may be reimbursed by federal health programs, creating the potential for unnecessary or wasteful spending."
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TrumpRx Denounced as Corrupt Scheme to Line Pockets of Big Pharma—and Don Jr.
"Trump has dressed up yet another corporate giveaway as a boon to patients," said one watchdog. "Real drug price reform doesn’t look like a website."
Feb 06, 2026
US President Donald Trump on Thursday launched a website, branded with his name, in a purported effort to help patients buy prescription drugs at lower prices.
But experts, watchdog groups, and Democratic lawmakers said TrumpRx will likely do little for consumers—or for the broader goal of bringing down exorbitant medicine costs—while further enriching Big Pharma and potentially lining the pockets of his eldest son, Donald Trump Jr.
TrumpRx.gov, launched in partnership with pharmaceutical giants, points users to direct-to-patient sales platforms hosted by drug companies to facilitate the purchase of an extremely limited selection of medications. For example, TrumpRx's listing for Farxiga links users to AstraZeneca Direct, where patients can pay out of pocket for the type 2 diabetes medication.
Donald Trump Jr. is on the board of BlinkRx, a prescription drug platform that stands to benefit from the Trump administration's promotion of direct-to-patient medicine sales. In December, the president's son reportedly met with top drug company executives and administration officials responsible for regulating the pharmaceutical industry—a gathering hosted by BlinkRx.
Frank Pallone Jr. (D-NJ), the top Democrat on the House Energy and Commerce Committee, said in a statement Thursday that TrumpRx "not only threatens patients’ health, safety, and privacy, but also likely includes kickback schemes designed to enrich President Trump, his family, and their friends."
"TrumpRx has been shrouded in secrecy from the beginning because the administration clearly does not want anyone to know it likely won’t save patients money," said Pallone. "However, we do know Trump only slaps his name on things when there’s something in it for him."
Last week, a group of Democratic senators sent a letter to the inspector general of the US Department of Health and Human Services warning that "without stricter safeguards before its official launch, TrumpRx could be used as a potential vehicle for unlawful kickback schemes that result in excessive costs for the federal government."
In addition to sending users to direct-to-patient sales sites, TrumpRx offers Trump-branded coupons for some medications. To obtain a coupon, site users must accept terms that state: "You agree that by redeeming this coupon, you (and anyone else acting on your behalf) agree not to seek reimbursement from any insurance plan for out-of-pocket costs for prescriptions purchased with this coupon. You also agree not to count the cost of prescriptions toward your deductible or true out-of-pocket costs."
The Washington Post reported that pharmaceutical companies "have agreed to list their drugs on TrumpRx.gov."
"TrumpRx is designed to help Big Pharma keep its prices high by diluting the bargaining power of insurance companies, weakening an important check on pharma."
Experts warned that patients who use TrumpRx could end up paying more for their medications than if they pursued other available options.
"TrumpRx’s offerings are very limited, fewer than 50 drugs listed, and most are niche products used by few patients," Rena Conti, an associate professor at Boston University, told ABC News. "Many are available in generic form at even lower prices or already available to consumers at low or even very low prices elsewhere. This suggests it pays for consumers to check their insurance coverage and ask their regular doctor or pharmacist before they use this service."
Peter Maybarduk, access to medicines director at Public Citizen, offered a more scathing assessment of TrumpRx, saying the president has "dressed up yet another corporate giveaway as a boon to patients."
"Most patients will do better through their insurance than through TrumpRx. Many patients without insurance will not be able to afford drugmakers’ still-high prices funneled through TrumpRx," said Maybarduk. "But drugmakers certainly will appreciate TrumpRx’s free promotion of their products, delivered with a false veneer of price accountability. TrumpRx is designed to help Big Pharma keep its prices high by diluting the bargaining power of insurance companies, weakening an important check on pharma."
“TrumpRx also appears to be another example of this president’s repeated corruption," he continued. "Trump’s son, Donald Trump Jr., sits on the board of BlinkRx, a key business that may benefit financially from TrumpRx. Getting serious about medicine affordability means getting serious about challenging Big Pharma. For all Trump’s talk, Big Pharma is getting a lot of special favors from this White House, while patients still are waiting. Real drug price reform doesn’t look like a website."
Throughout his second White House term, Trump has made outlandish promises to cut drug costs and hosted top executives at the White House to tout splashy deals—only for pharmaceutical giants to continue jacking up prices. Reuters reported last month that drugmakers planned to "raise US prices on at least 350 branded medications, including vaccines against Covid, RSV, and shingles and blockbuster cancer treatment Ibrance" in 2026.
Merith Basey, CEO of Patients for Affordable Drugs Now, said in a statement that the Trump administration's "voluntary agreements" with drug companies "lack clear enforcement mechanisms and still put the power to set and increase prices firmly in the hands of pharmaceutical corporations."
"Patients in our community will soon learn if they can reliably access these discounts at the pharmacy counter, where the program will ultimately be tested and where affordability matters most," Basey said of TrumpRx.
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Big Pharma Army of 500 Lobbyists Is Coming for Medicare Prescription Drug Negotiations, Watchdog Warns
Lobbyists working to pass Pharma-backed legislation currently outnumber lobbyists working to oppose it by more than 20-to-1, estimates Public Citizen.
Nov 19, 2025
Government watchdog Public Citizen is warning that the pharmaceutical industry is preparing an all-out blitz aimed at sabotaging government efforts to negotiate lower prices for prescription drugs.
In a report released on Wednesday, Public Citizen said it found that the major pharmaceutical companies this year have hired more than 500 lobbyists to push for the passage of three pieces of legislation that would undermine the provisions allowing the government to negotiate lower drug prices contained in the 2022 Inflation Reduction Act.
The first piece, called the ORPHAN Cures Act, was passed by Congress in July after being stuffed into the One Big Beautiful Bill Act. According to Public Citizen, the law will "delay and exempt some of the most profitable drugs—including cancer treatments—from negotiations, representing tens of billions in annual Medicare spending."
The other two pieces of legislation—the EPIC Act and the MINI Act—have not yet been passed, and Public Citizen says that they "would lengthen the already long delay period before small molecule drugs are eligible for negotiation—effectively excluding many medicines from negotiations entirely or shortening the period patients have access to lower negotiated prices to only one or two years."
Public Citizen estimates that there are currently 501 lobbyists who are pushing to pass these laws, while just 24 lobbyists are working to block their passage. In total, notes Public Citizen, this means opponents of the legislation are outnumbered by a ratio of more than 20-to-1.
Steve Knievel, Public Citizen's access to medicines advocate, called on elected representatives to "reject the demands of pharma lobbyists and instead work to make prescription drugs more affordable" for their constituents.
"Instead of handing drug corporations billions of dollars by helping them evade price negotiations," Knievel said, "Congress should pass legislation to empower Medicare to negotiate lower drug prices on all costly medicines and allow all patients to access lower, negotiated prices, even if they don’t have Medicare."
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Short of Medicare for All, Sanders Offers Democrats 6 Other Ways to Tackle Healthcare Crisis
"There are a number of much-needed reforms to the healthcare system that we could offer now that would substantially improve the lives of the American people and are also incredibly popular."
Nov 18, 2025
As Americans face soaring health insurance premiums and a vote to extend expiring Affordable Care Act subsidies looms, Sen. Bernie Sanders argued in a Tuesday letter to Democratic lawmakers that "it is imperative that we all support that legislation, but we must do much more."
Congressional Democrats' fight for ACA subsidies led to the longest government shutdown in US history—which ended last week, after eight members of the Senate Democratic Caucus caved without securing any guarantees. Instead, as Sanders (I-Vt.) noted, Majority Leader John Thune (R-SD) agreed to hold a vote on extending the tax credits no later than the second week of December.
"At a time when the Republicans have been forced to finally talk about the healthcare crisis facing our country, it is essential that the Democratic Caucus unify behind a set of commonsense policies that will make healthcare more affordable and accessible," Sanders wrote. "The American people are paying attention. Now is the time to act."
Sanders, who caucuses with Democrats, is the ranking member of the Senate Committee on Health, Education, Labor, and Pensions. The panel's chair, Sen. Bill Cassidy (R-La.), is now pushing President Donald Trump's proposal to encourage Americans to shift to high-deductible plans and have the government put money directly into their health savings accounts.
"What Republicans are proposing is a bad deal for hardworking Americans, but a good deal for the wealthy," Jessica Schubel, who was a healthcare adviser to former President Joe Biden, explained Tuesday in a Fox News op-ed. "This new proposal could push millions into buying high-cost plans that make you pay thousands of dollars before they start paying for your care. Healthcare costs could skyrocket while undermining the entire Obamacare system—putting care at risk for millions of Americans."
Sanders' letter similarly warns that "while President Trump and some other Republicans in Congress are rightfully going after what they call 'the money sucking, BIG, BAD Insurance Companies,' the policies they have been discussing would make a bad situation even worse" by leading to "more medical bankruptcies, more unaffordable care, and more Americans going without the healthcare they desperately need."
The country's current debate over ACA subsidies has sparked fresh calls for a shift to government-funded universal healthcare, for which Sanders has long led the fight in Congress. He acknowledged that "while I believe that the long-term solution to the healthcare crisis is Medicare for All, and I appreciate the 16 cosponsors we have on that legislation in the Senate, and the more than 100 cosponsors we have in the House, this bill does not yet have majority support in the Democratic Caucus."
"The good news, however, is that there are a number of much-needed reforms to the healthcare system that we could offer now that would substantially improve the lives of the American people and are also incredibly popular," he continued.
Specifically, Sanders called for:
- Extending the ACA tax credits;
- Repealing Trump and congressional Republicans' $1 trillion in cuts to the ACA and Medicaid;
- Expanding Medicare to cover dental, vision, and hearing;
- Cutting the cost of prescription drugs by at least 50% with legislation requiring pharmaceutical companies to charge no more for medications in the United States than they do in Europe or Canada;
- Expanding primary healthcare with investments in the National Health Service Corps as well as community and teaching health centers; and
- Banning stock buybacks and dividends, and restricting CEO compensation.
"At a time when the vast majority of Americans understand that our current healthcare system is broken, dysfunctional, and cruel, we must offer serious proposals which begin to address the systemic deficiencies within American healthcare," he stressed. "We should not be defending a system which is not only, by far, the most expensive in the world, but one which numerous international studies describe as one of the worst."
For example, last year the US-based Commonwealth Fund examined 10 peer countries—Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and the United States—and found that "the US continues to be in a class by itself in the underperformance of its healthcare sector."
Without federal intervention, conditions in the US sector are on track to get worse. Thanks to expiring subsidies, soaring premiums, and Trump and GOP lawmakers' recent cuts in their so-called One Big Beautiful Bill Act, an estimated 15 million Americans could lose health insurance altogether over the next decade.
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'Heinrich Should Be Ashamed': Lone Senate Dem Helps GOP Deliver Big Pharma Win
The provision, part of the Senate budget bill, was described as "a blatant giveaway to the pharmaceutical industry that would keep drug prices high for patients while draining $5 billion in taxpayer dollars."
Jul 01, 2025
The deep-pocketed and powerful pharmaceutical industry notched a significant victory on Monday when the Senate parliamentarian ruled that a bill described by critics as a handout to drug corporations can be included in the Republican reconciliation package, which could become law as soon as this week.
The legislation, titled the Optimizing Research Progress Hope and New (ORPHAN) Cures Act, would exempt drugs that treat more than one rare disease from Medicare's drug-price negotiation program, allowing pharmaceutical companies to charge exorbitant prices for life-saving medications in a purported effort to encourage innovation. (Medications developed to treat rare diseases are known as "orphan drugs.")
The consumer advocacy group Public Citizen observed that if the legislation were already in effect, Medicare "would have been barred from negotiating lower prices for important treatments like cancer drugs Imbruvica, Calquence, and Pomalyst."
Among the bill's leading supporters is Sen. Martin Heinrich (D-N.M.), whose spokesperson announced the parliamentarian's decision to allow the measure in the reconciliation package after previously advising that it be excluded. Heinrich is listed as the legislation's only co-sponsor in the Senate, alongside lead sponsor Sen. John Barrasso (R-Wyo.).
"Sen. Heinrich should be ashamed of prioritizing drug corporation profits over lower medicine prices for seniors and people with disabilities," Steve Knievel, access to medicines advocate at Public Citizen, said in a statement Monday. "Patients and consumers breathed a sigh of relief when the Senate parliamentarian stripped the proposal from Republicans' Big Ugly Betrayal, so it comes as a gut punch to hear that Sen. Heinrich welcomed the reversal and continued to champion a proposal that will transfer billions from taxpayers to Big Pharma."
"People across the country are demanding lower drug prices and for Medicare drug price negotiations to be expanded, not restricted," Knievel added. "Sen. Heinrich should apologize to his constituents and start listening to them instead of drug corporation lobbyists."
The Biotechnology Innovation Organization, a lobbying group whose members include pharmaceutical companies, has publicly endorsed and promoted the legislation, urging lawmakers to pass it "as soon as possible."
"This is a blatant giveaway to the pharmaceutical industry that would keep drug prices high for patients."
The nonpartisan Congressional Budget Office has estimated that the ORPHAN Cures Act would cost U.S. taxpayers around $5 billion over the next decade.
Merith Basey, executive director of Patients For Affordable Drugs Now, said that "patients are infuriated to see the Senate cave to Big Pharma by reviving the ORPHAN Cures Act at the eleventh hour."
"This is a blatant giveaway to the pharmaceutical industry that would keep drug prices high for patients while draining $5 billion in taxpayer dollars," said Basey. "We call on lawmakers to remove this unnecessary provision immediately and stand with an overwhelming majority of Americans who want the Medicare Negotiation program to go further. Medicare negotiation will deliver huge savings for seniors and taxpayers; this bill would undermine that progress."
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Report Exposes Big Pharma Front Groups Posing as Patient Advocates
"When your board is stacked with industry insiders, your primary funding comes from pharma, and your talking points mirror those of drug lobbyists, you're not a patient advocacy organization—you're a PR operation."
May 19, 2025
A report published Monday reveals that a number of organizations claiming to represent the interests of patients are actually pharmaceutical industry front groups working against efforts to bring down drug costs in the United States, including by lobbying the Trump administration to scale back Medicare price negotiations.
The new analysis by Patients for Affordable Drugs Now (P4AD), which stressed that it doesn't take money from organizations that profit from the production or distribution of prescription medications, spotlights six groups: the Alliance for Aging Research, the American Action Forum, the Center for Medicine in the Public Interest, the Council for Affordable Health Coverage, the Pacific Research Institute, and Seniors 4 Better Care.
The featured organizations, according to P4AD, "are posing as independent patient or policy groups while acting as mouthpieces for the drug industry's agenda—all while raking in pharma cash, fighting Medicare negotiation, and pushing misleading claims to block reforms."
Seniors 4 Better Care, for instance, is a shell group of the American Prosperity Alliance, the president of which "has a history of lobbying for the healthcare industry, including for organizations at the Healthcare Association of New York and insurance providers such as MVP Healthcare," P4AD's report observes.
"The group's treasurer, Parker Hamilton Poling, is a former lobbyist for pharmaceutical companies like Roche and Cencora," the report notes. "Brian Berry, the organization's secretary, also has a history of lobbying for Chinese biotech companies like Complete Genomics."
Earlier this year, Seniors 4 Better Care bankrolled an ad that directly urged President Donald Trump to end the "pill penalty," a label the pharmaceutical industry has used to describe the treatment of small-molecule prescription drugs under the Inflation Reduction Act's Medicare price negotiation provisions.
Last month, in a major gift to Big Pharma and industry lobbyists, Trump signed an executive order aimed at delaying Medicare negotiations for small-molecule drugs, which represent 90% of prescription medicines currently in circulation.
Another group highlighted in P4AD's report is the Center for Medicine in the Public Interest (CMPI), which describes itself as "a nonprofit, nonpartisan research and educational organization that seeks to advance the discussion and development of patient-centered healthcare."
P4AD notes that "every single member" of the organization's board has ties to the pharmaceutical industry. Peter Pitts, CMPI's president and co-founder, "primarily worked at firms hired by the pharmaceutical industry following an 18-month stint at the Food and Drug Administration," P4AD's report states.
"While working at major firms, such as Porter Novelli, Pitts retained his role at CMPI and insisted it was not a conflict of interest," the report continues. "He also currently teaches at the University of Paris, Descartes School of Medicine, a department that is funded by AstraZeneca."
Merith Basey, P4AD's executive director, said that "when your board is stacked with industry insiders, your primary funding comes from pharma, and your talking points mirror those of drug lobbyists, you're not a patient advocacy organization—you're a PR operation."
"Polling shows that Americans are aware that pharmaceutical corporations are the primary drivers of high drug prices, which is why the industry funds front groups to mislead the public and protect its bottom line," said Basey. "Patients and policymakers deserve to know whose interests these groups truly represent."
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FTC Report Shows Big Pharma Middlemen Jack Up Prices by Up to 7,736%
Pharmacy benefit managers "are raking in billions in excess revenue—$7.3 billion over just five years—while squeezing independent pharmacies and leaving patients and health plan sponsors with skyrocketing costs."
Jan 14, 2025
The U.S. Federal Trade Commission on Tuesday published the second part of its investigation into how prescription drug middlemen are marking up the prices of specialty generic drugs dispensed at their affiliated pharmacies by hundreds—and in some cases, thousands—of percent, underscoring what advocates say is the need for urgent action by policymakers.
The FTC's second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health's Caremark Rx, Cigna Group's Express Scripts, and UnitedHealth Group's OptumRx—"marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually."
"Of the specialty generic drugs analyzed in this report and dispensed by the 'Big Three' PBMs' affiliated pharmacies for commercial health plan members between 2020 and 2022, 63% were reimbursed at rates marked up by more than 100% over their estimated acquisition cost... while 22% were marked up by more than 1,000%," the report states.
"For the pulmonary hypertension drug tadalafil (generic Adcirca), for example, pharmacies purchased the drug at an average of $27 in 2022, yet the Big Three PBMs marked up the drug by $2,079 and paid their affiliated pharmacies $2,106, on average, for a 30-day supply of the medication on commercial claims," the publication notes. That's a staggering average markup of 7,736%.
"The FTC's second interim report lays bare the blatant profiteering by PBM giants."
"Such significant markups allowed the Big Three PBMs and their affiliated specialty pharmacies to generate more than $7.3 billion in revenue from dispensing drugs in excess of the drugs' estimated acquisition costs from 2017-22," the FTC said. "The Big Three PBMs netted such significant revenues all while patient, employer, and other healthcare plan sponsor payments for drugs steadily increased annually."
The new analysis follows a July 2024 report that revealed Big Three PBM-affiliated pharmacies received 68% of the dispensing revenue generated by specialty drugs in 2023, a 14% increase from 2016.
"The FTC staff's second interim report finds that the three major pharmacy benefit managers hiked costs for a wide range of lifesaving drugs, including medications to treat heart disease and cancer," FTC Chair Lina Khan said in a statement Tuesday. "The FTC should keep using its tools to investigate practices that may inflate drug costs, squeeze independent pharmacies, and deprive Americans of affordable, accessible healthcare—and should act swiftly to stop any illegal conduct."
Khan's time as chair is limited. Republican U.S. President-elect Donald Trump's inauguration is next week and he has named Andrew Ferguson as the next FTC chair. As Ferguson is already on the commission, his elevation to chair won't require Senate confirmation.
Greg Lopes, spokesperson for the Pharmaceutical Care Management Association, a PBM lobby group, said Tuesday that "it's clear this report again fails to consider the entirety of the prescription drug supply chain and makes sweeping assertions about the role of PBMs disconnected from a full appreciation of their critical cost-saving role for employers, unions, taxpayers, and patients."
Last September, the FTC sued the Big Three and their affiliated group purchasing organizations for allegedly "engaging in anticompetitive and unfair rebating practices that have artificially inflated the list price of insulin drugs, impaired patients' access to lower list price products, and shifted the cost of high insulin list prices to vulnerable patients."
FTC Office of Policy Planning Director Hannah Garden-Monheit said Tuesday that the problem of PBM price inflation "is growing at an alarming rate, which means there is an urgent need for policymakers to address it."
To that end, U.S. Sens. Maria Cantwell (D-Wash.) and Chuck Grassley (R-Iowa) introduced the Pharmacy Benefit Manager Transparency Act of 2023, a bill backed by the AARP aimed at increasing transparency and "holding PBMs accountable for deceptive and unfair practices that drive up prescription drug costs and force independent pharmacies out of business."
"This report is a call to action for policymakers to dismantle these exploitative schemes."
Responding to the FTC report, Emma Freer, senior policy analyst for healthcare at the American Economic Liberties Project—a corporate accountability and antitrust advocacy group—said in a statement Tuesday that "the FTC's second interim report lays bare the blatant profiteering by PBM giants, which are marking up lifesaving drugs like cancer, HIV, and multiple sclerosis treatments by thousands of percent and forcing patients to pay the price."
"By steering prescriptions for the most expensive specialty generic drugs to their own pharmacies, PBMs are raking in billions in excess revenue—$7.3 billion over just five years—while squeezing independent pharmacies and leaving patients and health plan sponsors with skyrocketing costs," Freer added. "This report is a call to action for policymakers to dismantle these exploitative schemes, outlaw the rebate system driving up prices, and restore fairness and affordability to the U.S. healthcare system."
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'Unfit': Trump Nominates Dr. Oz to Run Medicare
"By nominating RFK Jr. and Mehmet Oz," said one public health expert, "Trump is giving his middle finger to science."
Nov 19, 2024
If confirmed to be the next U.S. secretary of health and human services, anti-vaccine activist Robert F. Kennedy Jr. could be working "closely" with another official who's infamous for his questionable health guidance: Dr. Mehmet Oz, who President-elect Donald Trump on Tuesday nominated to run the Centers for Medicare and Medicaid Services.
Trump said in a statement that if confirmed, Oz would "cut waste and fraud within our Country's most expensive Government Agency"—a plan that advocates for Medicare said would be carried out by privatizing the healthcare program that serves more than 66 million senior citizens.
As The Lever reported in 2022, Oz aggressively pushed Medicare Advantage plans on his show, The Dr. Oz Show, airing one segment about the insurance agency MedicareAdvantage.com and urging viewers to sign up for the program via a hotline. Insurance companies that offer Medicare Advantage plans are notorious for requiring "prior authorization" for doctors to provide certain medical procedures, subjecting patients to deceptive marketing, and harming senior citizens.
Considering his opposition to traditional Medicare, Matt Stoller of the American Economic Liberties Project said Oz "is not a good pick for a very powerful position in charge of a trillion dollars of healthcare spending."
The advocacy group Social Security Works noted that plans to "completely privatize Medicare" are also in Project 2025, the far-right policy agenda that Trump repeatedly tried to distance himself from while campaigning.
"Hands off our earned benefits!" said the group.
With Trump's support, Oz unsuccessfully ran to represent Pennsylvania in the U.S. Senate in 2022. The president-elect said Tuesday that if confirmed, Oz would work closely with Kennedy "to take on the illness industrial complex."
Kennedy's proposals for doing so include halting research on drug development, removing teeth-strengthening fluoride from drinking water, and firing Food and Drug Administration employees who have waged a "war on public health" through the "suppression" of the veterinary drug ivermectin and raw milk, which has been associated with disease outbreaks.
Oz has spent years peddling health advice, half of which University of Alberta researchers found to be "baseless or wrong" in a 2014 study published in the British Medical Journal. He promoted a study claiming coffee bean weight loss pills would "burn fat fast for anyone," but the research was later retracted. Oz also claimed that eating certain foods like red onion and endive could reduce a person's cancer risk by up to 75%, leading one paper published in the journal Nutrition and Cancer to assert, "Reality Check: There is no such thing as a miracle food."
Oz has also maintained close ties to multi-level marketing companies that promote products like vitamins with false claims about their ability to treat, cure, or prevent diseases.
"Dr. Oz is unfit to run CMS," said Lawrence Gostin, director of the O'Neill Institute at Georgetown University. "He peddles conspiracy theories on vaccines and fake cures. He profits from fringe medical ideas."
"By nominating RFK Jr. and Mehmet Oz," he added, "Trump is giving his middle finger to science. Having worked for 40 years in public health, it's utterly disheartening."
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US Drug Prices Still Far Higher Than Other Nations' Even After Medicare Talks
The U.S. "has always accepted that we are the country that overpays relative to the rest of the world," said one health policy expert.
Sep 03, 2024
The Biden administration's Medicare drug price negotiations yielded lowered costs for 10 commonly used drugs, and the White House said last month that Americans would save an estimated $1.5 billion in out-of-pocket expenses thanks to the talks—but an analysis out Tuesday found that the U.S. will still be paying far more than other wealthy countries.
Reuters reviewed the maximum prices that Australia, Japan, Canada, and Sweden have agreed to pay for nine of the 10 drugs for which Medicare negotiated prices this year, and found that the U.S. will still be paying more than double the amount for the medications on average.
The new prices are set to go into effect on January 1, 2026, but two of the highest prices the U.S. will still pay are for Imbruvica, for blood cancers, and Stelara, for conditions including Crohn's disease and psoriasis.
Medicare will be charged $9,319 for a 30-day supply of the latter drug, compared to $4,607 in Sweden. For Stelara, the U.S. will pay $4,695 under the negotiated prices—more than four times the amount it costs in Sweden, Australia, and Canada.
For Enbrel, which treats conditions including arthritis, Medicare will pay $2,355 per month—far less than the list price of $7,106, but still more than $1,000 over what Sweden is charged: $709. Australia pays $573, while Canada pays $704, and Japan pays just over $300 for the drug.
"The government negotiations are especially significant for drugs where market forces were most limited and therefore had the least impact on producing price concessions."
Stacie Dusetzina, a professor of health policy at Vanderbilt University, told Reuters that the U.S. has "always accepted that we are the country that overpays relative to the rest of the world."
The analysis comes two weeks after the Brookings Institution published a review of the impact of the United States' first federal negotiations of prescription drug prices, finding that just three of the drugs which had little competition in the market accounted for more than half of the $6 billion the U.S. is expected to save in 2026.
"The government negotiations are especially significant for drugs where market forces were most limited and therefore had the least impact on producing price concessions," said Brookings.
Reuters noted that in other countries, prices generally come down over time, but U.S. drugmakers are able to raise prices annually and often extend patents by making small changes to medications, stopping less expensive generic versions from hitting the market and saving patients money.
Unlike in other wealthy countries, Johns Hopkins Bloomberg School of Public Health scientist Mariana Socal told Reuters, "the longer a drug is in the U.S. market, the more we pay."
With previous list prices well into the hundreds and thousands for the 10 drugs included in negotiations so far, Medicare agreed to pay close to $200 for a 30-day supply for drugs including Xarelto, Jardiance, and Farxiga—medications for which other governments examined by Reuters pay $78 or less, thanks to their longstanding negotiations.
The RAND Corporation found in a study in February that before the Medicare negotiations were included in the Inflation Reduction Act, U.S. health plans paid more than three times as much as other countries for brand-name drugs, even after discounts.
"A contributor to higher U.S. per capita drug spending is faster uptake of new and more expensive prescription drugs in the United States relative to other countries," wrote researchers at the London School of Economics in a study in 2013. "In contrast, the other OECD countries employed mechanisms such as health technology assessment and restrictions on patients' eligibility for new prescription drugs, and they required strict evidence of the value of new drugs."
The researchers suggested pharmaceutical companies in the U.S., like in other countries, should be required "to provide more evidence about the value of new drugs in relation to the cost" and negotiate prices accordingly.
As Merith Basey, executive director of Patients for Affordable Drugs, said in August after the results of the first round of negotiations were announced, advocates are still pushing for far more savings in upcoming talks between Medicare and drug manufacturers, which are expected to start next year.
"We remain committed to expanding the Medicare negotiation program to more drugs," said Basey last month, "and fighting for additional reforms to lower drug prices for all patients who need relief."
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