Take Ozempic. In the United States, for the average patient paying out of pocket, the blockbuster diabetes drug can cost anywhere from $349 to more than $1,000 per month. It’s $349 through TrumpRx. Yet in several other wealthy countries, the highest price is $190 a month, according to KFF, a nonpartisan research group.
Enbrel is an even more striking example. A monthly supply of the rheumatoid arthritis drug costs $3,354 through TrumpRx, more than five times the $641 average in other countries where researchers found prices.
However, certain drugs come out on top. Rydapt, a drug used to treat certain blood cancers, costs $2,909 for 56 capsules through TrumpRx, less than half the price of $5,901 for the same amount in France, the second cheapest country.
These disparities extend across the site, according to the KFF analysis. The report, which did not compare TrumpRx’s savings in the United States, offers one of the first large-scale global comparisons of Trump’s drug pricing claims.
The analysis included 32 brand-name drugs sold through TrumpRx that lacked generic or biosimilar equivalents. Researchers focused on these drugs because patients don’t have the option to upgrade to cheaper versions, meaning the discounts offered by TrumpRx could have a bigger impact on what they pay.
The group compared prices with those in 11 other wealthy countries, including Canada, France, Germany, the Netherlands and the United Kingdom. Prices are in effect as of August 26.
The results were almost evenly distributed. For 17 of the drugs, TrumpRx prices were lower than average overseas prices. For 15, they were higher. But Trump promised Americans the lowest prices in the world. By this measure, the results were less favorable: only five were actually the cheapest, while 13 were the most expensive.
“It’s kind of a mixed bag,” said Juliette Cubanski, deputy director of the Medicare policy program at KFF, who co-authored the report. “Even with the discounts that may have been accepted by manufacturers who list their drugs on the TrumpRx website, the prices they offer, even with a discount, continue to be higher than prices in comparable countries.”
Drug price discounts vary widely
The findings offer a first look at the promises and limitations of Trump’s approach to lowering drug prices.
Americans generally pay more for prescription drugs than patients in other wealthy countries, even when the drugs are made by the same companies. The TrumpRx discounts, according to the White House, stem from Trump’s “Most Favored Nation” pricing agreements, deals with drugmakers to charge Americans the lowest prices they offer other countries in exchange for tariff relief. But discounts can vary widely, according to the analysis, and they haven’t always produced the lowest prices Trump promised.
“I’m not surprised by these results,” said Dr. Benjamin Rome, a primary care physician and health policy researcher at Harvard Medical School. “All of us who have been tracking drug prices realized that as soon as TrumpRx launched, these were a limited number of drugs and it was clear that the prices that existed were not always going to be linked or linked in any way to those in other countries.
This is a markedly different approach than that taken by Trump’s predecessor, Joe Biden.
Rather than using Medicare’s power to negotiate prices for a limited number of expensive drugs each year, TrumpRx relies largely on voluntary agreements with individual drugmakers to offer discounted prices directly to consumers. (The exact details of the agreements remain largely confidential and the White House has refused to release them.)
TrumpRx does not sell drugs directly. For many drugs, this refers consumers to manufacturer programs through which they can get coupons or discounted cash prices without insurance.
This is not how most people get their prescription medications. About 9 in 10 Americans have some form of health insurance, meaning many pay for their medications through private insurance, Medicare or Medicaid — although discounted cash payment options have become increasingly popular as insurance has become more expensive. Money spent on TrumpRx does not count toward a patient’s co-pay or deductible.
“These are highly selected products for which the manufacturer is willing to offer a discount,” Rome said. “Maybe these aren’t the products that drive the highest spending in the U.S. in some cases, or they’re products that they were already offering confidential discounts on, but now they’re making those discounts more public.”
The site now includes several cheaper generic medications. “But these generics and the low prices of these generics existed before the TrumpRx website,” Cubanski said.
Direct price comparisons are difficult
The KFF analysis does not take into account all drugs available through TrumpRx, and there are limits to what can be gleaned from it.
Antonio Ciaccia, CEO of 46brooklyn Research, a group that tracks drug prices in the United States, counts about 80 brand-name drugs currently on TrumpRx, while KFF was able to compare prices for 32.
Part of the challenge, Ciaccia explained, is that some drugs sold in the United States are not available in all of the countries KFF examines. This can make direct comparisons difficult.
“One of the big differences is that the U.S. market contains more products than international markets, which is notable in that we have options here in the U.S. rather than a one-size-fits-all processing approach,” he said.
International prices are also not always perfectly comparable, he added. The analysis relies on publicly available prices, which may not include confidential discounts negotiated between foreign governments and drugmakers.
Ciaccia also noted that KFF’s 11 comparison countries do not exactly match countries used in some of the administration’s international pricing programs.
The White House did not immediately respond to a request for comment.
Put the claim to the test
These limitations do not change the fundamental comparison that is at the heart of Trump’s claim: whether prices offered to Americans match or exceed those available abroad.
“We wanted to put that claim to the test with this analysis.” » said Cubanski. “There is no clear general trend towards higher prices nor a consistent trend towards lower prices.»
And the administration is increasingly asserting that that is exactly what it has accomplished.
“Over the past year, my administration has reached unprecedented deals with 26 of the world’s largest pharmaceutical companies, and the rest are all coming in very quickly, to provide their medicines to Americans at discounts of 60, 70, 80 and even 90 percent,” Trump said last month.
Health policy experts hope TrumpRx will eventually lower prices in the United States, but they say it’s too soon to know. One concern, however, is that as more drugmakers strike deals, they could also raise prices abroad, narrowing the gap without saving Americans any money.
“It’s not just that the U.S. price might go down, but another way to have a lower U.S. price is to have a higher international price, and so it could be that if we do this comparison again in a year, we might find that TrumpRxs are lower than international prices,” Cubanski said.
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