The Trump administration’s long-awaited prescription drug marketplace is officially live. TrumpRx rolls out amid uncertainty over its impact on prescription drug prices for everyday patients, raising both optimism and skepticism about whether Americans will actually save money at the pharmacy counter.
A New Push to Cut Drug Prices
TrumpRx, a direct-to-consumer prescription drug platform backed by the administration of Donald Trump, went live on Thursday after months of anticipation. Designed as a cornerstone of the president’s drug-pricing agenda, the platform aims to connect patients directly with pharmaceutical manufacturers willing to sell certain medications for cash—without using insurance.
The updated TrumpRx.gov site, first introduced last fall as a basic information hub, was formally unveiled at a White House event. Trump touted dramatic savings, saying patients would see prices “you’re not going to believe.”
How TrumpRx Works
The portal acts as a central marketplace where users can browse or search for medications. Depending on the drug, patients either receive a coupon to redeem at a local pharmacy or are redirected to a manufacturer’s existing direct-purchase website. The administration says discounts on the platform range from 33% to as much as 93%, though most hover around 50% off list prices.
Currently, about 43 medications are available, with officials promising more to come. Participating companies include major drugmakers such as Eli Lilly, Novo Nordisk, AstraZeneca, Pfizer, and Merck.
Highlighted prices include Eli Lilly’s obesity drug Zepbound starting at $299 per month and Novo Nordisk’s Wegovy pill listed as low as $149. Other offerings include AstraZeneca’s Bevespi inhaler for $51 and Pfizer’s Xeljanz for roughly $1,500 per month. However, some previously announced deals—such as Merck’s diabetes drug Januvia for $100—are not yet visible on the site.
Will Patients Actually Save Money?
Despite the fanfare, experts caution that lower list prices don’t always translate into real-world savings. Many Americans with insurance may still pay less by sticking with their coverage, especially once deductibles are met. TrumpRx itself warns insured users to compare their copays before opting to pay cash.
Some drugs on the portal are already available at similar prices elsewhere. For example, discount platforms like GoodRx list Pfizer’s menopause treatment Duavee for the same cash price offered on TrumpRx.
The Bigger Political Strategy
The administration has framed TrumpRx as part of a broader “Most Favored Nation” initiative, which also pressures drugmakers to offer Medicaid lower prices and launch new drugs in the U.S. at rates comparable to peer countries. Trump has increasingly leaned on the policy as a response to voter frustration over rising living costs, an issue that has weighed on his approval ratings ahead of the November midterm elections.
Experts See Limited Early Impact
Direct-to-consumer drug sales are not new. Billionaire entrepreneur Mark Cuban launched Cost Plus Drug Company in 2022, selling generics at cost plus a modest markup. More recently, Eli Lilly introduced LillyDirect, while Novo Nordisk rolled out NovoCare for Wegovy.
Trump’s push expands this model, aiming to cut out intermediaries like pharmacy benefit managers. Still, analysts say the biggest beneficiaries—at least initially—will likely be uninsured patients or those with very high deductibles.
“TrumpRx might support access and affordability for a very small number of people,” said Rena Conti of Boston University Questrom School of Business.
Joey Mattingly from the University of Utah College of Pharmacy noted that for patients with high deductibles, paying cash through TrumpRx could make sense—but only after careful comparison shopping.
Insurance Complications and Policy Shifts
A major concern is whether cash payments made through TrumpRx will count toward insurance deductibles. Without that, patients could spend hundreds each month without reducing their annual out-of-pocket limits.
Some movement is already underway. Express Scripts, owned by Cigna, recently agreed—pending regulatory changes—to count TrumpRx purchases toward deductibles after settling a dispute with the Federal Trade Commission.
Sticker Shock Still Possible
Even with deep discounts, some drugs may remain unaffordable. Stacie Dusetzina of Vanderbilt University Medical Center has warned that once monthly prices exceed $100, many patients stop filling prescriptions altogether.
She also questioned TrumpRx’s claim of offering the world’s lowest drug prices, noting that a Peterson-KFF Health System Tracker analysis found Novo Nordisk’s Ozempic selling for under $100 in several countries.
Obesity Drugs Are the Exception
Where TrumpRx may have the biggest impact is in obesity care. Weight-loss medications are often excluded from insurance coverage, making cash-pay options especially attractive. Novo Nordisk reports that about 30% of Wegovy prescriptions now come through NovoCare, with nearly all prescriptions for its new Wegovy pill routed through the self-pay channel.
Eli Lilly has seen similar momentum. CEO Dave Ricks said more than one million U.S. patients used LillyDirect in 2025, with Zepbound self-pay vials accounting for a significant share of new obesity drug users.
Still, analysts like Evan Seigerman of BMO Capital Markets note that enthusiasm may not extend to other drug categories. “People want their insurance to pay,” he said. “They’re not as excited to pay out of pocket for everyday medications.”
