TrumpRx set to launch, but it’s unclear if it will lower drug prices for most patients

By Tami Luhby, Adam Cancryn, CNN

(CNN) — TrumpRx, the Trump administration’s much-anticipated direct-to-consumer drug platform, is expected to launch on Thursday, according to two people familiar with the matter.

A key pillar of President Donald Trump’s effort to lower prescription drug costs, the website will serve as a clearinghouse that connects patients with drug makers selling certain products to those willing to pay cash and forgo insurance. The medications, including the blockbuster obesity drugs Zepbound and Wegovy, will be available at a discount through these channels.

However, it remains to be seen whether direct-to-consumer channels will actually result in lower costs for cash-paying patients with prescriptions. They could make certain drugs, particularly obesity medications that are not widely covered by insurance, more affordable, experts say. But many consumers could ultimately pay less for many other medicines over the course of the year if they go through their insurance.

At least 16 drug manufacturers have negotiated agreements with the administration to participate in the TrumpRx portal, though details remain scant on which medications will be available and at what prices. Some of the offerings listed in the announcements include Eli Lilly’s Zepbound and Novo Nordisk’s Wegovy for as little as $149 a month; Amgen’s cholesterol-lowering drug Rephatha for $239 a month; and Merck’s diabetes medication Januvia for $100.

Trump has touted the drug pricing push as a major step toward lowering Americans’ health care costs, one of their main affordability pain points. In addition to TrumpRx, the “Most Favored Nation” effort includes having drug makers provide medicine to Medicaid and launch their drugs in the US at the lowest price available in other peer countries.

The president has grown increasingly enthusiastic about the new portal and his administration’s broader drug pricing initiative, viewing it as a key plank in his bid to ease the voter anxiety over cost-of-living issues that has weighed down his approval ratings and raised concerns about Republican candidates’ fate in the midterm elections in November.

Impact on costs

The idea of selling medications directly to consumers did not originate with the Trump administration. Entrepreneur Mark Cuban launched his online pharmacy, Cost Plus Drug Company, in 2022 to sell generic medications directly to consumers at its cost plus a 15% markup. It now offers some brand-name medicines.

Eli Lilly started providing obesity, migraine and diabetes drugs through LillyDirect early in 2024, and Novo Nordisk unveiled NovoCare, where patients could purchase Wegovy directly from the company, just over a year later.

Trump has pushed to expand direct-to-consumer sales, which he sees as a way reduce costs by cutting out other players in the drug supply chain, such as pharmacy benefit managers. He has pointed to seemingly massive discounts available on TrumpRx when announcing the deals at the White House, though those savings are off of the drugs’ list prices, which don’t always reflect what patients actually have to pay.

The effort has garnered mixed reviews from experts, but they largely say the channels’ impact will be limited – at least initially.

“TrumpRx might support access and affordability for a very small number of people,” said Rena Conti, an associate professor at the Boston University Questrom School of Business.

Much will depend on the drug, its cash-pay price and the insurance the patient has, if any. Typically, consumers’ co-pays or co-insurance will be lower than the prices available on the channels – at least once they satisfy their deductibles.

Those who have smaller deductibles may find it more cost-effective to go through their insurance. But for those with high deductibles, it may be worth it to purchase medicines through TrumpRx, Joey Mattingly, an associate professor at the University of Utah’s College of Pharmacy, told CNN. It will require consumers to do some research.

One important consideration is whether insurers will allow the cash payments to drugmakers to count towards their insurance deductibles. Otherwise, patients could wind up shelling out hundreds of dollars a month for medications without having that expense chip away at their annual deductibles, which could be thousands of dollars.

That shift may already be starting to happen. Express Scripts, a major pharmacy benefit manager owned by Cigna, reached a settlement with the Federal Trade Commission on Wednesday over accusations of artificially inflating insulin prices. As part of the agreement, Express Scripts will count payments its members make through TrumpRx towards their deductibles and out-of-pocket maximums, provided certain legislative or regulatory changes are made.

Although Trump is touting the price cuts that will be available, some patients may experience sticker shock when shopping on TrumpRx.

“Even when you have very large discounts provided for brand-name drugs, they still end up with prices that are not really that affordable to the average person,” Stacie Dusetzina, a health policy professor at Vanderbilt University Medical Center, said at a November briefing hosted by KFF, a health policy research group. “We know from research that once a price goes above about $100 a month, that a lot of people stop filling their drugs at that price point.”

While drug makers have yet to release the full list of products they’ll sell through the portal, the medications that have been announced have raised some eyebrows among experts. Some are strong sellers that are being made available at sizeable discounts, while others are older medications, have inexpensive generic alternatives or are being offered at prices likely comparable to what drugmakers receive from insurers.

The growth of the direct-to-consumer channels may also lead to some unintended consequences, said Mariana Socal, associate professor of health policy at Johns Hopkins University. Insurers could say they no longer need to cover the medications since patients now have direct access to them, for example.

Obesity drugs are different

The direct-to-consumer channel is growing in importance for some manufacturers, particularly Novo Nordisk and Eli Lilly.

Americans have been flocking to NovoCare and LillyDirect to purchase discounted weight loss medications even before TrumpRx launches. The drugmakers had already lowered their prices for cash-paying customers, though the Trump administration negotiated even deeper cuts.

Prescriptions via Novo Nordisk’s self-pay channel account for about 30% of total prescriptions for Wegovy, the company said in latest financial report released Tuesday. Roughly 90% of prescriptions for the new Wegovy pill are coming through NovoCare.

Meanwhile, Zepbound self-pay vials are Eli Lilly’s most popular offering and make up a third of new patients starting on any brand-name obesity drug, the company said during its earnings call on Wednesday.

“The number of people engaging with our US direct-to-patient platform, LillyDirect, increased to over 1 million patients in 2025,” Dave Ricks, Eli Lilly’s CEO, said on the call.

One reason behind the popularity of cash-pay portals for obesity drugs is that many patients don’t have the option of going through their insurers since the medications aren’t covered. But other medicines may not command the same interest, especially if using insurance is an option.

“I don’t think people are as excited to pay for blood thinners out of pocket,” said Evan Seigerman, senior pharmaceutical analyst at BMO Capital Markets. “They want their insurance to pay for it.”

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