Introduction
I am writing this because I have not seen much media coverage about this new program.
Americans have long known they pay more for pharmaceutical medications than people in other countries. It was reported that, at times, they paid 1,000% more than other countries for the same medications, manufactured in the same factories and provided at the same dosage.
This prompted the Trump administration to pressure pharmaceutical companies to follow the Most-Favored-Nation price plan.
The opening page of the official website lists an injectable hormone medication available in a dosing pen. The US price was listed as $1,449, while the same medication was available in Canada for $342 for an auto-injection pen. The new price under TrumpRx lists that medication at $295.
What The Current Rollout Includes
This is the initial rollout of the program, and it will certainly continue to evolve.
Currently, it is a cash-only program; you cannot use your insurance. I am sure pharmaceutical companies will come along slowly on accommodating insurance companies to take advantage of this new pricing model.
Here is an important concept to consider: most insurance plans with pharmacy benefits include a deductible paid by the patient, and the insurance benefit contributes its portion after that. There will be times when the deductible exceeds the cash price if you purchase through TrumpRx.
Here are additional examples from the official website: original price for Wegovy was $1,349/month, and the Most-Favored-Nation price is $149/month. Original Ozempic pen price was $1,028, and the TrumpRx price is $199/month.
How Access Works And What Comes Next
Not all drugs are covered. More are coming as pharmaceutical companies agree to the Most-Favored-Nation pricing schedule. Awareness and increased public pressure will be persuasive in pushing both insurance companies and pharmaceutical companies to recognize the importance of reducing drug costs in the United States.
There is a coupon program offered on the website to make access to these pricing schedules easier. Some pharmaceutical companies are only offering MFN pricing if you go to the trouble of going to the manufacturer's website.
You will still need to get a prescription from your healthcare provider and submit the Rx and the coupon to the pharmacy where you arrange this pricing. This will vary depending on whether the company authorizes a coupon code you can take to your pharmacy, or requires you to go through the added inconvenience of sending the prescription to the manufacturer. This will be identified for each drug on the website.
This is a new program and will likely expand rapidly as awareness increases and more drugs become available.