As the White House gears up its election-year pitch taking credit for lowering prescription drug prices, it faces a key unknown: Will voters notice any difference?
Why it matters: One of President Trump's primary answers to concerns about affordability may fall on deaf ears if patients don't see results — and policy experts have warned many won't.
Driving the news: Trump will almost certainly point to his pricing deals with leading drugmakers during Tuesday's State of the Union, along with the launch of TrumpRx, a direct-to-consumer sales platform.
- The White House is preparing to make health care central to its midterms pitch, CNN recently reported, and has urged congressional Republicans to codify its "most favored nation" policies tying U.S. prices to what's paid abroad.
- While that's highly unlikely, the administration is comfortable pitting its drug pricing agenda against Democrats' messaging on costs and access and making 2026 yet another health care-dominated election.
The big picture: Trump's deals yielded commitments from more than a dozen companies to offer steeper Medicaid discounts, tie the launch prices of new drugs to those paid in other developed countries, invest in domestic manufacturing and participate in TrumpRx.
- But based on what's publicly known about the details, most Americans aren't likely to notice much of a difference outside of a few key drugs, experts say.
- And though the administration has signaled it wants to expand most-favored nation pricing to Medicare, it would only apply to a limited number of drugs and isn't expected to have a large impact — assuming the plan survives legal challenges.
- That means Trump's campaign messaging may run counter to voters' lived reality.
How it works: The main pillars of the agreements with manufacturers aren't designed to have much of an impact on what most patients actually pay for their prescription drugs.
- Lowering Medicaid prices may save the government money, but most Medicaid patients already get their drugs for free, or have nominal co-pays.
- And though the prices being offered through TrumpRx are lower than the drugs' list prices, most patients don't pay the list price of a drug. Instead, they get it covered through their insurance.
- More than half of the drugs being offered through TrumpRx additionally have or soon will have generic equivalents, which are much cheaper.
Many experts believe drug companies will delay launching new products, to avoid having to sell them for less in the U.S. market.
- But regardless of what happens, it's hard to sell someone on the idea that the new drug they're taking is cheaper than it would have been because of Trump.
- "While the announcements sound substantial, the reality is the vast majority of Americans will not see any decrease in what they pay at the pharmacy, which limits the political benefit to Republicans in my view," said Raymond James analyst Chris Meekins, a senior health official in Trump's first-term administration.
Yes, but: There's a high-profile exception.
- Trump's deal with Eli Lilly and Novo Nordisk expanded Medicare coverage for the companies' popular anti-obesity drugs for certain populations in exchange for concessions on cash-pay prices.
- A significant share of anti-obesity drugs still are bought outside of insurance, since many payers don't cover them.
- That means lower cash-pay prices will be meaningful for a substantial number of patients, and Medicare coverage will open the door for many seniors to gain access to the injectables and pills for the first time.
What they're saying: "There's been a lot of hoopla from the White House on drug pricing, but not a lot of action that will lower costs for a meaningful number of patients," said KFF's Larry Levitt.
- "President Trump deserves credit for keeping the issue of high drug prices on the agenda, but his bark has been stronger than his bite," Levitt said.
- White House spokesman Kush Desai said: "President Trump delivered historic wins for Americans with his most-favored nations drug pricing deals and TrumpRx.gov, especially for patients who use GLP-1s, fertility treatments, and other prescription drugs not typically covered by insurance."
- "This is just the beginning, however, of President Trump's health care affordability agenda," he added, noting the administration is negotiating with more drugmakers and working with Congress on codifying broader drug pricing discounts.
Between the lines: The details of the agreements remain confidential, meaning all that's known are the top-line takeaways published in press releases or included in Oval Office announcements.
- Plenty of health reforms have been sold — successfully or not — on the promise of delivering future benefits.
- But the authors of those reforms could point to independent analyses of their legislation or regulation. In this case, Trump and drug manufacturers are asking voters to take them at their word.
The bottom line: Taking on prescription drug companies is undoubtedly good politics.
- But if voters ultimately aren't seeing clear results — at least outside of anti-obesity medications — then Trump's drug pricing deals may not be the political boon the White House wants them to be.
