What Long Islanders should know about Trump Rx and drug prices

The federal government’s new TrumpRx site may save some consumers money, but many would pay more for medication through the federal website than if they obtained medications through their insurance, by using generics, or through other online discount sites, experts said. 

“It certainly isn’t a broad-based solution to the problem of high drug prices in the U.S.,” said Juliette Cubanski, deputy director of the Program on Medicare Policy at the health-policy nonprofit KFF.

New Yorkers without insurance, or those with very high deductibles, would benefit most from TrumpRx, said Linda Green, a professor emerita of healthcare management at Columbia Business School. It’s a relatively small number of people, because of the high rate of insurance coverage in New York, she said. 

The TrumpRx website went live Thursday night with a few dozen drugs, including popular weight loss medications, available at deep discounts from the manufacturers' list prices.

But consumers typically don’t pay those list prices, usually using insurance, existing discount programs like GoodRx or the Cost Plus website cofounded by billionaire Mark Cuban, said Rena Conti, an associate professor at Boston University's Questrom School of Business.

Cost Plus has more than 2,000 discounted medications, she said. TrumpRx has 43, although the Trump administration said it will add more.

For those buying drugs outside of insurance, TrumpRx is not always a good deal, especially when there are generic alternatives.

For example, the brand name of the drug pantoprazole, Protonix, which is used to treat acid reflex, heartburn and other conditions, is $200.10 for 30 tablets using a TrumpRx coupon, the same price available on GoodRx. But the generic version is available for as little as $6.07 on Cost Plus and as little as $9.87 on GoodRx.

The discounts are available through coupons presented at pharmacies or via manufacturers’ websites.

TrumpRx is an alternative for people with insurance who take GLP-1 drugs for weight loss, because many insurers either have never covered them or stopped doing so because of their high cost, Cubanski said. Prices on TrumpRx vary from $149 to $499, depending on the dosage and form of the drug.

“It’s a steep discount, but it’s still an out-of-pocket expense that many people will still struggle to afford, and that’s the case for a lot of these medications,” Cubanski said.

Consumers can find the same prices on the GLP-1 manufacturers’ own websites, although the prices for some doses and versions fell following an agreement with the Trump administration announced in November.

In addition, some of the offers on TrumpRx have expiration dates, such as discounts for Novo Nordisk’s Ozempic pen that are only good through March 31.

The fertility drug Gonal-F appears to be the one medication that is cheaper on TrumpRx than any other website, and is typically not covered by commercial insurers, Conti said. A multi-dose vial on TrumpRx is $252. The same vial starts at $1,399 on GoodRx.

Although TrumpRx generally won’t save money for people who can use their insurance, one benefit of the website is the clear posting of prices, said Carrie Chan, a professor of health care management and the faculty director of the health care and pharmaceutical management program at Columbia Business School.

“Price transparency is something that we desperately need in order to address the cost crisis within health care,” she said.

Websites like GoodRx and Cost Plus also post prices.

Conti said consumers should shop around, looking at TrumpRx and other discount sites, and at their own insurance policies and the copays and deductibles. They also should talk with their pharmacists, she said.

TrumpRx advises consumers: “If you have insurance, check your co-pay first — it may be even lower.”

Cubanski said although TrumpRx is another option in comparing prices, it may make a complicated prescription drug system even more frustrating for consumers.

“It feels like we’re creating an environment that is putting the onus on the patient, especially patients who don’t have great insurance coverage or any insurance coverage, to figure out what the best deal is for them,” she said. “And when you’re sick and need of a medication, that really may not be where you want to be.”