What Trump got right and wrong about drug pricing during State of the Union
Trump touted lowering drug prices as one of his biggest achievements.
During the State of the Union on Tuesday night, President Donald Trump pointed to lower drug prices as an achievement of the first year of his second term.
Trump said he is "ending the wildly inflated cost of prescription drugs," adding that past administrations were unable to do so.
"I got it done under my just-enacted most favored nation agreements. Americans who, for decades, paid by far the highest prices of any nation anywhere in the world for prescription drugs, will now pay the lowest price anywhere in the world for drugs," Trump said.
"I took prescription drugs, a very big part of health care, from the highest price in the entire world to the lowest. That's a big achievement," he added.
Experts tell ABC News that Trump has made some achievements in drug pricing, such as reducing the costs of some in-vitro fertilization (IVF) medications through targeted drug discounts for cash payers and encouraging employer-provided coverage.
However, they add that many of the other reductions in drug prices were either started under the administration of former President Joe Biden or through market pressures, especially for weight loss drugs.
"It's impossible to make a blanket saying about prices being lowered. It really depends on where any individual sits in their circumstance," Kaye Pestaina, vice president at KFF, a nonpartisan health policy research organization, told ABC News. "For one individual, they might get some discounts and some significant ones. For another individual, that has employer coverage, it might be cheaper to use their insurance and then nothing has changed for them."
Some experts told ABC News that Trump is correct in saying that the U.S. has been paying some of the highest drug prices in the world. According to one recent study from the RAND Corporation, a nonprofit global policy think tank, U.S. drug prices run about 2.7 to 4.2 times the costs other wealthy nations pay for the same medicines.
In the recently announced "Great Healthcare Plan," Trump proposed to make permanent his administration's "most favored nation" drug pricing agreements -- also known as MFN -- to ensure the U.S. does not pay more for prescription drugs than other similar countries, according to KFF.
Under this policy, the administration has been able to secure voluntary price reduction agreements with 16 pharmaceutical companies. The companies pledged to offer discounts on some drugs for people who don't have insurance or who pay cash, though the details of many of these deals aren't entirely clear.
Pestaina said the lack of transparency makes it difficult to evaluate sweeping claims about those agreements.
"To the extent about the MFN-negotiated prices, it's impossible to review since we don't have any access to what those deals were," she told ABC News.
Trump has touted these discount arrangements, featuring them on his new website TrumpRx.
However, TrumpRx itself does not lower prices at the pharmacy because it doesn't sell drugs, Pestaina explained.
The website simply shows consumers discounted "self-pay" prices and links them to manufacturer sites or coupons, many of which are already available outside the platform, she said
"You can go on TrumpRx.gov, download a coupon, and then present it at the pharmacy when you're getting your medicine," Benjamin Jolley, senior fellow for healthcare at the American Economic Liberties Project, told ABC News "So long as you are not using your insurance, you can get a reduction in your cost because the manufacturer is paying the pharmacy a coupon, functionally."
Pestaina added that the TrumpRx website currently only lists 43 drugs.
"There are thousands of FDA-approved medications. So it's a drop in the bucket at the moment," she said.
Jolley also said that many of the price reductions the administration highlights are due to the Inflation Reduction Act, which was signed into law by Biden.
That bill created significant incentive for manufacturers to reduce the prices of their drugs, primarily because they would have to pay substantial rebates to pharmacies under the Medicare drug price negotiation program.
Jolley noted that manufacturers were already under competitive and political pressure to reduce prices. For example, the fierce competition among GLP-1 weight-loss drugs like Zepbound and Wegovy had already pushed manufacturers to lower prices and offer direct-to-consumer discounts before TrumpRx launched.
"But those agreements only apply to people without insurance or paying cash," he said, adding that many people covered by insurance will likely pay far less than the cost listed on the website.
Jolley, who is a pharmacist, said that he has not yet seen sweeping day-to-day reductions in what patients pay at the counter that can be clearly attributed to executive actions taken during Trump's second term.
Pestaina also cautioned against broad generalizations about savings. She said that proposed policies have faced legal and industry pushback and have not yet broadly lowered prices across the U.S. market.
However, some experts say Trump did make some significant price reductions.
During his speech, Trump referenced a deal made last year between his administration and pharmaceutical company EMD Serono to reduce the cost of some fertility medications.
EMD Serono, the largest fertility drug manufacturer in the world, agreed to provide discounts for the cost of fertility drugs the company sells in the U.S., including its most popular, Gonal-f, a fertility medication used to stimulate egg development in women and, in certain cases, sperm production in men, according to the administration.
Officials told ABC News last year that a fertility drug typically costs between $5,000 and $6,000 per cycle and only about 30% of families have access to some sort of employer-based coverage. EMD Serono will list its fertility drugs online at "very, very heavily reduced prices," Trump said at the time.
During his speech on Tuesday, Trump pointed out a woman in the audience who -- he said -- benefited from the deal. Before the website discount, he said she used an IVF drug that cost her around $4,000 per cycle of treatment, out of pocket.
The same types of treatments are now listed on TrumpRx for about $500, a reduction of up to 90%.
Jolley said if Trump was referencing Gonal-f, this would to be a meaningful price reduction. But IVF still remains expensive, especially if not covered by insurance.
"The discounted medication only covers a portion of the total expense, and procedures, tests, ultrasounds, egg retrieval, lab work and embryo transfer still add thousands of dollars to the overall cost," he said.
Ishani D. Premaratne, MD, is an integrated plastic & reconstructive surgery resident and member of the ABC News Medical Unit.
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