What’s TrumpRx, and how does it compare to other DTC options?

It’s no secret US drug prices are much higher than the rest of the world—nearly 2.8x higher for branded and generics in 2022, in fact, the Department of Health and Human Services reported.

President Trump has been outspoken about the cost of drugs in the US, and health research organization KFF reported over half of adults in the country are “very worried” or “somewhat worried” about affording their prescription medications.

Both public and private solutions have come forward to address these expenses, including the $35 insulin cap established in the Inflation Reduction Act or drug discount companies creating initiatives like GoodRx’s couponing and direct-to-consumer (DTC) options like billionaire Mark Cuban’s Cost Plus Drugs.

On Sept. 30, the Trump administration announced a new public-private program to lower drug costs. Called TrumpRx, the partnership with pharma giant Pfizer intends to sell drugs directly to patients at prices 40%–85% cheaper than usual and doesn’t go through insurance, according to press releases.

The administration said patients can navigate to TrumpRx.gov starting in 2026 and find price discounts for drugs from Pfizer, including topical ointment Eucrisa, arthritis medication Xeljanz, and migraine treatment Zavzpret.

While the program started with Pfizer—boosting its stock by 7% after the announcement and helping the company potentially avoid pharmaceutical tariffs for three years—the administration said it plans to expand its partnerships. As of Oct. 10, it has already started that process, announcing a partnership with AstraZeneca that offers discounts ranging from 96% to 654% off the undefined “deal price” of three respiratory drugs. Exact prices are still private, however.

“Anything that makes drugs—particularly new drugs—more accessible to consumers is a positive,” Gary Zammit, president and CEO of contract research organization Clinilabs, told Healthcare Brew. “What is yet to be seen is whether or not other pharmaceutical companies will come on board and to what extent the benefits of TrumpRx will be extended to the general population.”

How does it compare? Programs to lower drug prices are not new. In fact, the Trump administration and Pfizer’s DTC partnership is similar to the Cost Plus Drugs model, where patients purchase medication directly from drugmakers, avoiding pharmacy benefit managers (PBMs) and providing options for people without insurance.

PBMs have long been accused of driving up drug prices, and these DTC programs like TrumpRx and Cost Plus Drug intentionally avoid the intermediary.

Cost Plus Drugs is mostly for generics, however, whereas the Trump administration is taking a company-by-company approach to expand into branded drug discounts.

Cost Plus didn’t respond to a request for comment, though its founder, Cuban, wrote in an X post the same day as the announcement that the initiative “will be amazing” for Cost Plus’s business since its “overhead and markups are lower than everyone else.”

How much cheaper, really? But Rajiv Leventhal, senior analyst in digital health at research firm eMarketer, told us there isn’t a big difference between TrumpRx and what already exists on the market.

Big pharmaceutical companies already have DTC sites, like Lilly Direct by Eli Lilly, Pfizer for All, and NovoCare through Novo Nordisk. These sites also offer discounts: For example, customers can get 50% off Lilly’s popular weight loss medication Zepbound through Lilly Direct.

Around the time of the program announcement, more companies (including Amgen and AstraZeneca) launched their own DTC websites to sell medications, potentially opening the door for them to distribute drugs through TrumpRx in the future, Leventhal said.

Still, “there’s really no difference here,” Leventhal said, except TrumpRx is creating one central marketplace to make it easier for patients to find the DTC offerings.

“It’s not going to affect most people, and that’s because the drugs are still going to be very high [in price],” he said, adding that most people get their medications through insurance and typically only pay out of pocket if they have a high deductible or the drug isn’t covered by their plan.

Zavzpret, for example, can cost over $1,000 out of pocket for six doses, according to Leventhal and drug price comparison company SingleCare. Even if the medication is discounted 50%, $500 would still be out of reach for most people, he said.

“There’s probably a small subset of patients that maybe can save some money through these offerings, but I would say it’s a very small subset,” Leventhal said.