Trump Says TrumpRx Prices Are the World's Lowest. 13 of 32 Drugs Are the Highest.

The Midterm Pitch Meets a Spreadsheet

Here's the setup. With the Nov. 3 midterms closing in, Trump has been hammering his drug pricing deals as the thing that will save his party. "This one thing alone should win us the midterms," he said at the White House, according to NBC News.

It's a bold bet. The promise is simple, memorable, and easy to repeat from a podium: the lowest prices in the world. No asterisks, no fine print, no "for select medications." Just the lowest, anywhere.

Then KFF, a nonpartisan research group, sat down and actually checked. In a Peterson-KFF Health System Tracker brief, researchers compared brand-name drugs on TrumpRx against listed prices in 11 other wealthy countries: Australia, Austria, Belgium, Canada, France, Germany, Japan, the Netherlands, Sweden, Switzerland and the United Kingdom. TrumpRx listed 79 brand-name drugs by Aug. 25, but only 39 of them have no generic or biosimilar equivalent, and KFF limited the comparison to those. Thirty-two of the 39 had public prices in at least one of the other countries, and those 32 are the drugs in the analysis. TrumpRx prices were current as of Aug. 25.

Five Wins, Thirteen Disasters

The results were almost evenly split on the soft question of whether TrumpRx beat the average price abroad. For 17 drugs it did. For 15 it didn't. Fine. A coin flip is not exactly a revolution, but it's something.

The gap is lopsided in both directions, though. The 17 drugs that came in under the peer average did so by up to 63 percent, about 31 percent on average. The 15 that came in over it were, on average, 262 percent more expensive than the peer average, and nine of them cost more than double. The wins are modest. The losses are not.

But that's not the claim. The claim is the lowest price in the world, and on that measure the scorecard collapses. Only five of the 32 drugs were actually the cheapest. Thirteen were the single most expensive among all the countries compared.

Put differently, the program is more than twice as likely to hand you the worst price on the planet as the best one. "It's kind of a mixed bag," said Juliette Cubanski, deputy director of the Medicare policy program at KFF, who co-authored the report. That is the polite, academic way of saying the boss is overselling.

The Roll Call of the Thirteen

KFF's full interactive table lists every drug, and the thirteen where TrumpRx had the highest price of any country compared are: Enbrel, Estring, Invokana, Ngenla, Orencia SC, Otezla, Ovidrel, Ozempic Pen, Premarin Vaginal Cream, Relenza, Trulicity, Viracept and Zepbound KwikPen. The list runs from arthritis and psoriasis drugs (Enbrel, Orencia SC, Otezla) to diabetes and weight-loss drugs (Invokana, Ozempic, Trulicity, Zepbound), a growth hormone for children (Ngenla), menopause and fertility treatments (Estring, Premarin Vaginal Cream, Ovidrel), an HIV drug (Viracept) and a flu drug (Relenza).

Read the thirteen with a small asterisk, though. Two of them, Premarin Vaginal Cream and Viracept, were compared against exactly one other country. For Premarin that country is Canada, where it runs $19 against $237 on TrumpRx, more than ten times the price.

The five wins deserve the same scrutiny. Duavee, a menopause drug, is cheapest on TrumpRx at $30, against $47 in Belgium, the only other country where KFF found a price. The Zepbound vial is the cheapest by $1, and the Netherlands is the only comparison country. The other three, Rydapt, Praluent and Tresiba, beat fields of seven to nine countries, which is a much harder test and a much more impressive result.

Ozempic and Enbrel Tell the Real Story

Let's look at the specifics, because they're ugly. An American paying out of pocket for Ozempic can face anywhere from $349 to more than $1,000 a month. Through TrumpRx it's $349. Sounds like a deal until you learn that the next-highest price among the other countries is $190 a month, and France pays $84.

The other weight-loss shots tell the same story. Zepbound KwikPen maintenance doses cost $449 on TrumpRx against $423 in the next-highest country, and only Germany charges more than TrumpRx for Wegovy Pen, $427 to $349.

Then there's Enbrel, the rheumatoid arthritis drug. A monthly supply costs $3,354 through TrumpRx. The average in the other countries where researchers found prices is $641. That's more than five times higher. For a discount program.

To be fair, and we try to be, some drugs do come out well ahead. Rydapt, a treatment for certain blood cancers, runs $2,909 for 56 capsules through TrumpRx. In France, the next-cheapest country, the same amount costs $5,901. That's a genuine win for patients who need it. It's also one cherry on a sundae that's mostly spoiled.

What KFF Says Its Numbers Can't Tell You

KFF is careful about what its comparison does and doesn't show, and so should we be. It uses retail list prices converted to U.S. dollars, with no adjustment for each country's cost of living. In some countries the listed price is what the national health system reimburses, not what a patient would pay at the counter, and the German prices came from the country's largest pharmacy. For the 24 drugs with public prices in both the U.S. and Germany, German prices were higher on 14 of them.

None of that turns "the lowest prescription drug prices anywhere in the world" into a fact. It is, though, why Juliette Cubanski calls the picture a mixed bag and not a verdict.

What TrumpRx Actually Is

The site launched in February with a few dozen brand-name drugs and now lists more than 800 brand-name and generic medications. The White House says the discounts come from "most favored nation" deals, agreements where drugmakers charge Americans the lower prices they offer other countries in exchange for tariff relief.

But the machinery is murkier than the slogan. The site relies on GoodRx's pricing data and technology to power many of its listings, and it blends pre-existing drugmaker discounts with newly negotiated prices. So some of what you're seeing as a Trump triumph was already on the shelf.

And the details of the actual agreements? Largely confidential. The White House has declined to disclose them. So the public is being asked to believe in the lowest prices in the world based on deals nobody is allowed to read.

Handshake Deals vs. Actual Negotiation

This is a sharply different approach from Joe Biden's. Rather than use Medicare's power to negotiate prices for a limited number of costly drugs each year, TrumpRx runs largely on voluntary agreements with individual drugmakers to offer discounted prices directly to consumers.

Voluntary. As in, the companies agree to what they feel like agreeing to. Dr. Benjamin Rome, a primary care physician and health policy researcher at Harvard Medical School, wasn't shocked by the findings. "Any of us who have been following drug prices realized, as soon as TrumpRx was launched, it was a limited number of drugs and it was clear that the prices that were there were not always going to be linked or in any way related to what the prices are in other countries," he said.

As for whether regular Americans have "saved a fortune," as Trump promised, nobody knows. Prescription drug prices fell 3.1% over the year ending in July, per federal inflation data, but experts say it's too soon to know how much of that, if any, belongs to TrumpRx. Also worth remembering: KFF's report didn't compare TrumpRx prices to what Americans would otherwise pay within the U.S.