A Major Shift in the Pharmaceutical Industry

Authored by: Victoria Wroblewski

Art by: Lindsey Li

The United States government has changed the future of pharmaceutical drug purchasing forever. The President of the US, Donald J. Trump, has launched an official pharmacy for Americans: TrumpRX. The TrumpRX initiative formed a partnership with the pharmaceutical companies Pfizer and AstraZeneca in order to install a direct-to-customer (DTC) program through a website called TrumpRX.gov [1]. The drugs are discounted to match the prices of other developed countries, making them more affordable for consumers. The goal for the initiative is to encourage cost savings in the health industry, as well as generate greater accessibility measures to Americans who are often faced with unprecedentedly high prices compared to those of other countries [2]. This is known as advancing most-favored-nation pricing [3]. While this does have the potential to address price discrepancies, it could disincentivize drug innovation, having more detrimental effects in the long-term.

There is a growing concern surrounding the rising price of medications. In society, over 82% of individuals believe that the cost of prescription drugs is unreasonable. About 55% of American adults responded to a poll indicating that they were worried about affording prescription drugs, and 33% admitted to not taking required prescription drugs because of high costs [4]. One of the most common examples is insulin. 1 in 5 of American adults younger than 65 and diabetic reported rationing insulin due to its high cost [5]. This is detrimental to the health of numerous individuals worldwide. This initiative has the potential to mitigate pharmaceutical greed and implement a successful platform that will help Americans purchase necessary medications at affordable prices. The prescription drugs and pharmaceutical prices are projected to be reduced from 30% to 80% [6]. On the other hand, the price reductions only have the power to help a specific segment of Americans. This poses a risk to the profit margins of Pfizer, AstraZeneca, and the future pharmaceutical companies that join, since the prices of goods that have high R&D costs will be significantly lowered. 

The TrumpRX initiative is predominantly focused on helping individuals who are uninsured and paying out-of-pocket prices, or those who are underinsured. This is because the site will allow for the purchase of drugs at a lower price without the use of insurance coverage. More specifically, this will only benefit those who can make the purchase without using their insurance to cover a part of the cost. Over 90% of Americans are insured, so they would have to make the choice of using their insurance or purchasing under TrumpRX [7]. This website only helps about 10% of the nation, and even with major discounts, the prices may still be unaffordable for the population it is targeting. Likewise, vulnerable populations are frequently unaware of the government assistance programs that are available to them. There is a correlation between lower education status and less awareness of such assistance opportunities, so this program may not reach those individuals successfully [8].

The administration recently placed 100% tariffs on imported brand-name drugs with the goal of pressuring companies to lower their prices and shift manufacturing to within the nation. By joining TrumpRX, companies cooperate directly with the government and avoid all tariff implications and gain protection in return for lowering their prices. In this case, Pfizer was granted a tariff exemption for three years in return for joining TrumpRX [9]. With Pfizer taking the lead, many companies may feel inclined to join the initiative. However, the companies may face problems with their previous distribution partners since sales would shift towards greater direct-to-consumer (DTC) opportunities. It is important to note that DTC could have a positive impact in the sense that it encourages individuals to take a more active role in managing their conditions and seeking the care they need. On the other hand, it could also pressure physicians to satisfy patient needs, leading to inappropriate prescribing processes based on biased information [10].  

From only benefitting a tenth of the nation, with no guarantee of achieving success, there is a threat that the implementation of TrumpRX may only have short-term sustainability. Nonetheless, it has the potential to increase price transparency and increase the United States commitment to domestic investment. Considering these factors, is TrumpRX just a flashy announcement without a lot of real impact? 

References: 

1. Essley Whyte, L., Rockoff, J. D., & Loftus, P. (2025, October 2). Inside Pfizer’s drug-pricing deal with the Trump administration. The Wall Street Journal. https://www.wsj.com/health/pharma/trump-pfizer-drug-price-tariff-deal-455be9b7?mod=Searchresults&pos=6&page=1

2. K. Ho, & A. Pakes, Policy options for the drug pricing conundrum, Proc. Natl. Acad. Sci. U.S.A. 122 (9) e2418540122, https://doi.org/10.1073/pnas.2418540122 (2025).

3. Bagley N, Garthwaite C, Ippolito B. Most-Favored-Nation Drug Pricing—How Courts Could Shape Future Health Regulation. JAMA Health Forum. 2025;6(10):e255440. doi:10.1001/jamahealthforum.2025.5440

4. Sparks, G., Kirzinger, A., Montero, A., Valdes, I., & Hamel, L. (2024, October 4). Public opinion on prescription drugs and their prices. KFF. https://www.kff.org/health-costs/public-opinion-on-prescription-drugs-and-their-prices/

5. Fang, M., & Selvin, E. (2023). Cost-related insulin rationing in U.S. adults younger than 65 years with diabetes. JAMA, 329(19), 1700–1702. https://doi.org/10.1001/jama.2023.5747

6. Jacobson, L. (2025, May 16). Fact-checking Trump’s claim that prescription drug price drops could happen almost immediately. PBS NewsHour. https://www.pbs.org/newshour/politics/fact-checking-trumps-claim-that-prescription-drug-price-drops-could-happen-almost-immediately

7. Scott, D. (2025, October 3). Will TrumpRx save me money on drugs or not? Vox. https://www.vox.com/health/463602/what-is-trump-rx-prescription-pharmaceutical-drugs

8. Federman, A. D., Safran, D. G., Keyhani, S., Siu, A. L., & Halm, E. A. (2008). Low levels of awareness of pharmaceutical cost-assistance programs among inner-city seniors. JAMA, 300(12), 1412–1414. https://doi.org/10.1001/jama.300.12.1412

9. Pfizer Inc. (2025, September 30). Pfizer reaches landmark agreement with U.S. Government to lower drug costs for American patients. https://www.pfizer.com/news/press-release/press-release-detail/pfizer-reaches-landmark-agreement-us-government-lower-drug 

10. Franquiz, M.J., McGuire, A.L. Direct-to-Consumer Drug Advertisement and Prescribing Practices: Evidence Review and Practical Guidance for Clinicians. J GEN INTERN MED 36, 1390–1394 (2021). https://doi.org/10.1007/s11606-020-06218-x