White House launches direct to consumer drug site

President Donald Trump on Thursday announced the launch of TrumpRx — a direct-to-consumer website that is key to his administration’s efforts to lower prescription drug costs in the U.S. 

The president said millions of Americans would save money through TrumpRx, but it’s still unclear if all patients — particularly those with insurance coverage — will see more cost savings from using that site to buy their medicines. TrumpRx targets people who are willing to pay with cash and forgo insurance, which suggests that people without or with limited coverage may benefit the most. 

The site is not expected to sell drugs directly to American patients, but will act as a central hub that points them to drugmakers that are offering discounts on certain products on their own direct-to-consumer sites. For example, Eli Lilly and Novo Nordisk were already offering their blockbuster obesity drugs at hefty discounts to cash-paying patients, even before the reductions Trump touted on Thursday.

In recent months, both companies and at least 14 other drugmakers have negotiated agreements with the Trump administration to participate on the platform and voluntarily sell certain medicines at a discount to Medicaid patients. Those landmark deals are part of Trump’s broader “most favored nation” policy, which pushes to link U.S. drug prices to the lowest ones abroad.

It is the government’s latest effort to try to rein in U.S. prescription drug prices, which are two to three times higher on average than those in other developed nations — and up to 10 times more than in certain countries, according to the Rand Corp., a public policy think tank.

But TrumpRx “doesn’t seem like it is the only solution” to that issue for most Americans, said Juliette Cubanski, deputy director of the program on Medicare Policy at KFF, a health policy research organization. The cash-pay offerings could be better deals for patients without insurance, but it’s difficult to assess exactly how many people stand to benefit from TrumpRx, she added.

“If they’re able to get a drug covered by their insurance at a relatively affordable copay, then there’s not a great upside to using the TrumpRx website,” Cubanski said.

She said people with insurance coverage who buy through direct-to-consumer platforms may also not have their purchases count toward their benefits, which means it doesn’t help them meet their deductible or out-of-pocket maximum.

But Cubanski said there’s potential for TrumpRx to be helpful in expanding access to certain drugs at more affordable prices, particularly medicines not covered widely by insurance in the U.S., such as obesity drugs. Medicare will start covering weight loss treatments for the first time later this year as part of the deals Lilly and Novo struck with Trump, but many employers are still hesitant to cover those drugs.

Still, many of the other products expected to be listed on TrumpRx are already widely covered through insurance, and some are available as cheaper generics from competing drugmakers.

But those list prices are often far higher than what private insurers and government programs ultimately pay for medicines after rebates, discounts and other concessions, according to researchers at Georgetown’s Medicare Policy Initiative. That suggests some payers may already be securing prices comparable to — or lower than — the newly announced discounts on medications under the Trump deals.

The Georgetown researchers cited one study that found that average discounts on brand-name drugs in Medicare Part D run around 40% of list prices. Meanwhile, discounts in Medicaid exceed 75%, according to a Congressional Budget Office study.

In the private sector, “we’ve got insurers and pharmacy benefit managers negotiating lower prices and designing an insurance benefit that enables people to benefit from those price negotiations,” said KFF’s Cubanski.

“My guess is that for most drugs, at least most brand-name medications, people are likely to get a better deal using their insurance rather than purchasing a drug through a direct-to-consumer website,” she said.

But available information from recent drug pricing deals indicates many widely used drugs will have discounted prices listed on the site:

• Ozempic injection for diabetes, made by Novo Nordisk: $350 per month, down from around $1,000
• Wegovy injection for obesity, made by Novo Nordisk: $350 per month, down from around $1,350
• Wegovy pill for obesity, made by Novo Nordisk: $150 per month for the starting doses
• Zepbound injection for obesity, made by Eli Lilly: $350 per month, down from $1,086
• Trulicity for diabetes, made by Eli Lilly: $389 per month, down from about $1,000
• Emgality for migraines, made by Eli Lilly: $299, down from around $764
• Repatha for lowering cholesterol, made by Amgen: $239, down from $573
• Reyataz for HIV, made by Bristol Myers Squibb: $217, down from $1,449
• Januvia for diabetes, made by Merck: $100, down from $330
• Epclusa for hepatitis C, made by Gilead: $2,425, down from $24,920
• Jentadueto for diabetes, made by Boehringer Ingelheim: $55, down from $525
• Xofluza for flu, made by Genentech: $50, down from $168 
• Advair Diskus inhaler 500/50, made by GSK: $89, down from $265
• Mayzent for multiple sclerosis, made by Novartis: $1,137, down from $9,987
• Plavix, made by Sanofi: $16, down from $756

In an interview with CNBC at a conference in January, Bristol Myers Squibb CEO Chris Boerner said the company has multiple products on its existing direct-to-consumer platform, which first offered a cash-pay discount on its blood thinner Eliquis. That platform will link to TrumpRx, he said.

The company is going to examine ways to put additional products in its portfolio on its own platform, “where it makes sense,” Boerner added. He said Bristol Myers is “aligned with the administration” on the issue of the U.S. health care system being too complex, and said several middlemen can increase costs.

“What we like about these [direct-to-consumer models], where they make sense from a business standpoint, is you’re able to circumvent some of that,” Boerner said.

Meanwhile, in an exclusive interview with CNBC last week, Eli Lilly CEO Dave Ricks said the company was the first drugmaker to sell obesity treatments directly to patients, and that TrumpRx is “taking that and expanding it across the industry” to other medicines.

“We’re all for that,” Ricks said.