A Comprehensive Analysis of TrumpRx
- Mike Rawaan
- 1 day ago
- 9 min read
February 13, 2026 | Pharmacy, Pharmacy Benefits, Prescription Drugs
Mike Rawaan, Founder and Managing Director
TrumpRx.gov is a federal direct-to-consumer (DTC) drug pricing portal launched on February 6, 2026. It does not sell medications directly; rather, it functions as a coupon aggregator and referral hub that connects cash-paying patients with manufacturer discount programs and direct-to-consumer purchasing channels. The platform is built on GoodRx technology and is the product of "Most Favored Nation" (MFN) pricing deals the Trump administration negotiated with 16 pharmaceutical manufacturers beginning in September 2025.
Drugs Covered and Scope
Number of drugs at launch: 43 brand-name medications from five manufacturers (AstraZeneca, Eli Lilly, EMD Serono, Novo Nordisk, and Pfizer). The administration has stated drugs from the remaining 11 manufacturers with signed agreements will be added in the coming months.
As a percentage of all prescribed drugs in the U.S.: The 43 drugs represent an extremely small fraction of the prescription drug landscape. The FDA has approved over 20,000 different prescription drugs for marketing. By comparison, GoodRx lists over 6,000 drugs, and Cost Plus Drugs offers more than 2,300 medications. Critically, TrumpRx offers only brand-name drugs—no generics—while 91% of all U.S. prescriptions are filled with generics, according to the FDA. This means TrumpRx's current scope covers well under 1% of all available prescription medications and targets only the ~9% of prescriptions that are brand-name.
Generic overlap concern: According to drug pricing expert Anna Kaltenboeck (president of Verdant Research), 20 of the 43 drugs listed on TrumpRx at launch already have generic alternatives available at significantly lower prices. Another six contain components available as generics or compounded products. STAT News independently confirmed that at least 18 brand-name drugs on TrumpRx are cheaper as generics elsewhere.
Therapeutic categories covered include: GLP-1 weight loss/diabetes drugs (Ozempic, Wegovy, Zepbound, Mounjaro), fertility medications (Gonal-F, Cetrotide, Ovidrel), respiratory drugs (Airsupra, Bevespi, Advair Diskus), diabetes medications (insulin lispro, Xigduo XR, Farxiga, Januvia, Janumet), autoimmune conditions (Xeljanz), cardiovascular drugs (Eliquis, Repatha), migraine treatments (Zavzpret, Emgality, Aimovig), and antidepressants (Pristiq).
Discounts Offered
Range: Discounts range from 33% to 93% off list price, depending on the drug and manufacturer.
Lowest discount: 33% off Pfizer's Xeljanz (autoimmune)
Highest discount: 93% off EMD Serono's Cetrotide (fertility)
Average: Many drugs are listed at approximately 50% off list price, with Pfizer's initial deal averaging ~50% discounts
Important caveats about advertised discounts:
Discounts are calculated from list prices, which are often far higher than what insurers, PBMs, and government programs actually pay after rebates and negotiations. As Georgetown's Medicare Policy Initiative researchers have noted, list prices do not reflect the real transaction prices in the system.
The site itself warns: "This is an out-of-pocket price. If you have insurance, check your co-pay first—it may be even lower."
Select price examples from the White House fact sheet:
Drug | Condition | List Price/mo | TrumpRx Price/mo | Stated Discount |
Ozempic (injectable) | Diabetes | $1,028 | ~$350 avg | ~66% |
Wegovy (injectable) | Weight loss | $1,349 | $199–$349 | 74–85% |
Wegovy (pill) | Weight loss | $1,349 | As low as $149 | Up to 89% |
Zepbound | Weight loss | $1,088 | ~$346 avg ($299+) | ~68% |
Gonal-F | Fertility | $1,449/pen | ~$355/pen | ~76% |
Cetrotide | Fertility | $329 | $22.50 | 93% |
Trulicity | Diabetes | $987/mo | $389/mo | ~61% |
Protonix | Acid reflux | $447 | $200 | 55% |
Who Qualifies?
Eligibility:
Anyone with a valid U.S. prescription can use TrumpRx
The platform is designed for cash-paying patients only
Patients must attest they are not enrolled in a government insurance program (Medicare, Medicaid) and will not seek insurance reimbursement
Some specific drug offers have additional eligibility criteria
Who benefits most (per expert consensus):
The ~27.2 million uninsured Americans (8.2% of the population)
Patients whose insurance does not cover specific medications (particularly GLP-1 weight loss drugs and fertility treatments)
Patients with very high deductibles who haven't met them yet
The underinsured
Who is unlikely to benefit:
The ~84% of Americans with prescription drug coverage—for most, insurance copays will be lower than TrumpRx cash prices
Medicare beneficiaries (who have a Part D out-of-pocket cap as of 2026)
Medicaid enrollees (who already pay little to no copays)
As KFF's Juliette Cubanski stated: "There's no clear advantage for most people to use TrumpRx to purchase their medications."
Insurance and TrumpRx
Does TrumpRx accept insurance? No. The platform explicitly states: "At this time, TrumpRx discounted pricing is only available for cash-paying patients."
Will purchases count toward insurance deductibles? Generally, no. Cash purchases through TrumpRx are unlikely to count toward insurance deductibles or out-of-pocket maximums. This is a critical limitation—patients using TrumpRx forgo progress toward their annual cost-sharing limits.
Future possibility: As part of an FTC settlement, Express Scripts (Cigna's PBM) has agreed to count TrumpRx purchases toward members' deductibles and out-of-pocket maximums, contingent on relevant legislative or regulatory changes. Trump's proposed "Great Healthcare Plan" would also "enable coverage of TrumpRx.gov purchases under health plans." Neither has been enacted as of this writing.
Types of insurance NOT compatible with TrumpRx at present:
Medicare Part D
Medicaid
Commercial/employer-sponsored (purchases are outside the benefit)
ACA marketplace plans
Price Comparison: TrumpRx vs. CVS vs. Insurance vs. Cost Plus Drugs
The following comparison illustrates pricing across channels for select medications. Prices are approximate and may vary by location, dosage, and coverage.
Example 1: Protonix (pantoprazole) — Acid Reflux
30 tablets, 20mg
Channel | Price | Notes |
CVS (no insurance, list price) | ~$447 | Brand-name Protonix |
CVS (with commercial insurance) | $10–$35 copay typical | Most plans cover generics preferentially |
TrumpRx | $200 | 55% discount off list |
GoodRx coupon (generic) | ~$10.47 | Pantoprazole generic |
Cost Plus Drugs (generic) | ~$6 | Pantoprazole generic |
Takeaway: TrumpRx's $200 price for brand Protonix is vastly more expensive than the $6–$10 generic available through Cost Plus Drugs or GoodRx. Insurance copays for the generic would typically be even less.
Example 2: Ozempic (semaglutide) — Diabetes/Weight Management
1mg dose, monthly supply
Channel | Price | Notes |
CVS (no insurance, list price) | ~$1,028/mo | No generic available |
CVS (with insurance, after deductible) | $25–$150 copay typical | If covered; varies widely |
TrumpRx | ~$350/mo | MFN pricing |
Cost Plus Drugs | Not available | No generic exists; brand not carried |
GoodRx coupon | ~$800–$900 | Limited discounting on brand |
Takeaway: For patients without insurance coverage for Ozempic, TrumpRx offers meaningful savings over list price. However, insured patients with coverage will typically pay less through their plan.
Example 3: Pristiq (desvenlafaxine) — Antidepressant
50mg, 30 tablets
Channel | Price | Notes |
CVS (no insurance, list price) | ~$450+ | Brand-name |
CVS (with insurance) | $10–$30 copay typical | Generic widely covered |
TrumpRx | ~$200 | ~50% off list |
GoodRx coupon (generic) | ~$25–$30 | Desvenlafaxine generic |
Cost Plus Drugs (generic) | ~$16.65 | Desvenlafaxine generic |
Takeaway: Like Protonix, the generic alternative is dramatically cheaper through Cost Plus Drugs or GoodRx than the brand on TrumpRx.
Example 4: Wegovy (semaglutide) — Weight Loss (injectable)
Monthly supply
Channel | Price | Notes |
Cash price (no insurance) | ~$1,349/mo | List price |
Commercial insurance | Often not covered for weight loss | Limited coverage |
TrumpRx | $199–$349/mo | Depending on dose |
Novo Nordisk DTC (pre-TrumpRx) | $199–$349/mo | Same pricing through NovoCare |
Cost Plus Drugs | Not available | No generic exists |
Takeaway: GLP-1 weight loss drugs represent TrumpRx's strongest value proposition, since many insurers don't cover them for weight loss. However, the same prices were already available through Novo Nordisk's own DTC channel before TrumpRx launched.
Example 5: Cetrotide (cetrorelix) — Fertility
Prefilled syringe + vial
Channel | Price | Notes |
Cash price (no insurance) | ~$329 | Rarely covered by insurance |
Commercial insurance | Typically not covered | Fertility exclusion common |
TrumpRx | $22.50 | 93% discount |
GoodRx | ~$309 | Brand pricing |
Cost Plus Drugs (generic) | ~$49.50 | Generic cetrorelix |
Takeaway: Fertility drugs represent TrumpRx's clearest win. Mark Cuban himself praised TrumpRx's fertility pricing as "going to be a lifesaver for a lot of couples."
TrumpRx vs. Mark Cuban's Cost Plus Drugs: Key Differences
Feature | TrumpRx | Cost Plus Drugs |
Type | Government portal/coupon hub | Online pharmacy |
Drugs offered | 43 brand-name (at launch) | 2,300+ (mostly generics) |
Drug type | Brand-name only | Primarily generics |
Pricing model | MFN pricing / manufacturer coupons | Cost + 15% markup + $5 pharmacy + $5 shipping |
Insurance accepted | No | Yes (26+ insurance providers) |
Sells drugs directly? | No (referral platform) | Yes |
Typical savings | 33–93% off list price | 70%+ off retail for generics |
Best for | Uninsured; drugs without generics (GLP-1s, fertility) | Generic medications across broad categories |
Mark Cuban noted at the Silicon Slopes Summit that for drugs carried by both platforms, Cost Plus is cheaper on approximately 90% of them. However, he credited TrumpRx for "crushing it" on fertility drug pricing.
Expert and Stakeholder Assessments
Supportive perspectives:
Dr. Ashish Jha (former Biden COVID response coordinator) called TrumpRx "a good thing" that is "going to be really, really helpful for people who don't have health insurance."
Chris Klomp (CMS Medicare Director) stated: "Now there are two sites on the internet with transparent lists of prices."
Skeptical perspectives:
KFF's Juliette Cubanski: "For most Americans, it's probably not a long-term solution to the affordability challenges they face."
Dr. Ben Rome (Brigham and Women's Hospital): "For the vast majority of people, it's going to continue to be less expensive for patients to purchase their medicines using their insurance."
Avalere Health's Milena Sullivan: Described the initiative as part of "a series of evolutions" rather than a transformative overnight change; significant questions remain about real-world impact.
PhRMA (industry trade group): While individual member companies participated, PhRMA noted the deals don't address PBM markups or 340B hospital pricing abuses that drive costs.
Advisory Board coverage: Quoted FamiliesUSA's Anthony Wright calling TrumpRx "a trumped-up catalog of coupons" that "steers consumers to the existing drug company programs for uninsured patients that have been around for a while."
Drug Channels Institute's Adam Fein: Has flagged TrumpRx alongside broader DTC trends as part of evolving market dynamics, noting manufacturers' strategies to offset payer pricing pressure.
Fortune: Despite having deals with 16 companies, manufacturers increased prices on over 800 brand-name drugs at the beginning of 2026 by a median of 4%.
Key Limitations and Open Questions
Narrow scope: 43 drugs vs. 20,000+ FDA-approved medications
Cash-only: Excludes the 84% of Americans with prescription drug coverage from meaningful benefit
No deductible credit: Purchases don't count toward insurance cost-sharing
Generic overlap: Over half of listed drugs have cheaper generic alternatives
Durability: Discounts are tied to voluntary manufacturer agreements and tariff exemptions—no legislation codifies the pricing
Legal concerns: Senate Democrats have raised questions about potential anti-kickback statute violations and conflicts of interest (notably, Donald Trump Jr.'s appointment to the board of BlinkRx, which reportedly helped build the TrumpRx platform)
Accessibility: Digital-only platform may disadvantage elderly, rural, or offline patients
Transparency: KFF noted that the details of MFN agreements "remain confidential"
Sources
White House Fact Sheet, "President Donald J. Trump Launches TrumpRx.gov to Bring Lower Drug Prices to American Patients," February 6, 2026
White House Fact Sheet, "President Donald J. Trump Announces Major Developments in Bringing Most-Favored-Nation Pricing to American Patients," November 6, 2025
CBS News, "TrumpRx: See the 43 drugs available on the Trump administration's new discounted drug site," February 6, 2026
NPR, "TrumpRx drug discounts," February 5, 2026
PBS NewsHour, "How effective will TrumpRx be at lowering prescription drug prices for Americans?" February 2026
STAT News, "What to know about TrumpRx, the Trump administration's prescription drug platform," February 5, 2026
STAT News, "TrumpRx promises cheapest drugs. Many cost less already," February 6, 2026
The Hill, "How much will TrumpRx really cut down your drug costs?" February 8, 2026
CNN, "TrumpRx launches, but it's unclear if it will lower drug prices for most patients," February 5, 2026
NBC News, "Trump launches discount drug platform: What to know," February 5, 2026
Advisory Board, "TrumpRx has launched. Will it actually help consumers?" February 10, 2026
Axios, "TrumpRx list of drugs: More than half have cheaper alternatives," February 6, 2026
Fortune, "TrumpRx is here and it helps, though a bit less than advertised," February 11, 2026
CNBC, "White House launches direct-to-consumer drug site TrumpRx. Here's what to know," February 5, 2026
Mintz Law, "Pharmaceutical Policy in Motion Continued: Trump Inks Nine New Drug Pricing Deals," December 23, 2025
Aon Insights, "Trump Administration Prescription Drug Initiatives: What Employers Should Know," November 2025
Truveris, "TrumpRx and MFN Pricing: What Plan Sponsors Should Know," November 17, 2025
Avalere Health, via Managed Healthcare Executive, "Here are the Pfizer Drugs to be Offered Through TrumpRx," September/October 2025
PhRMA Statement on Drug Pricing Executive Orders (via Managed Healthcare Executive), 2025
Drug Channels Institute (drugchannels.net), 2025–2026 coverage of DTC trends, gross-to-net dynamics, and TrumpRx
Inc., "Mark Cuban Responds to TrumpRx Launch, Says His Cost Plus Drugs Saves More Money," February 2026
Deseret News, "Mark Cuban, Chris Klomp introduce prescription drug pricing platforms," February 6, 2026
Pharmaceutical Commerce, "Everything to Know About TrumpRx in 2026," February 2026
Pharmacy Times, "TrumpRx Launches, Offering Cash-Paying Patients Discounted Drugs," February 2026
SingleCare/FDA, Prescription Drug Statistics, 2025 (FDA marketing approvals, generic share data)
AMCP, "Federal Update: Trump Administration Announces Deal to Bring Most-Favored-Nation Pricing to GLP-1s"
KFF (Kaiser Family Foundation), various analyses cited throughout on insurance coverage, beneficiary impact, and MFN deal transparency
Buchanan Ingersoll & Rooney, "TrumpRx: What Pharmacies and Plan Sponsors Need to Know," October 2025
The World Data, "TrumpRx Statistics in US 2026," February 2026
MMM Online / Avalere Health, "Policy 2026: MAHA-style makeover and regulation revamp set the tone for 2026," December 2025
About Covalence Health: Covalence Health works with healthcare investors and executives to separate signal from noise. Our team brings 250+ years of collective healthcare industry experience to help VC and PE firms evaluate opportunities, conduct operational due diligence, and drive strategic planning post-acquisition. We focus on what matters: helping portfolio companies achieve the operational improvements and growth trajectories that deliver returns.
Comments