These biotechs launched DTC platforms to take part in TrumpRx. But do stakeholders care?

With medication costs in the US still about nearly 3x higher than some other countries, the Trump administration has made it a mission to cut drug prices.

One of its initiatives to do so includes TrumpRx, a public-private program created to dispense certain drugs through a standardized marketplace directly to patients’ homes. Pfizer was the first to join the platform in September, and AstraZeneca announced its own deal soon after.

Pfizer’s stock shot up 6.8% and AstraZeneca’s rose 10% following the deal announcements. The program works through direct-to-consumer (DTC) platforms, which companies like Eli Lilly and Novo Nordisk already have. Other biotechs like Amgen, Bristol Myers Squibb, and Novartis launched DTC platforms in response to the new program, which means they could be added to the TrumpRx site when it goes live in 2026.

However, experts previously told Healthcare Brew DTC may not move the needle much on cutting costs for patients due to the fact that DTC programs work mostly out of pocket rather than through insurance. While there may be some cases where patients can use insurance, the programs are designed to be an option for people without insurance, who want out-of-pocket discounts, or whose plan doesn’t cover certain drugs. Some drugs, even at a discount, still cost hundreds of dollars out of pocket.

Q3 earnings reports are out, and projections show a 3.4% increase in pharmaceutical prices in 2026, according to healthcare performance improvement company Vizient, leaving questions about how much of a difference DTC will ultimately make for patients and the businesses alike.

Earnings breakdown. Pfizer’s stock may have had a jump following the TrumpRx announcement, but the biotech still reported a 7% operational decline YoY in Q3.

In its Q3 earnings, Pfizer referenced the agreement with TrumpRx and its plans to offer some of its drugs at a discount. The deal also provided a “three-year grace period” to alleviate Pfizer from tariffs, according to the Nov. 4 earnings press release.

Similarly, AstraZeneca mentioned the deal and tariff exemption in its earnings, but there also wasn’t a clear boost in revenue to its DTC site.

On Nov. 6, the Trump administration also reached a deal with weight loss drug makers Eli Lilly and Novo Nordisk to offer GLP-1s for as low as $245 per month through TrumpRx. Both Lilly and Novo shares dipped slightly after the news.

Amgen saw a bump in Q3 earnings, with the the Wall Street Journal crediting TrumpRx and investment in US manufacturing for the boost.

Otherwise, Bristol Myers Squibb beat expectations in its earnings but didn’t mention TrumpRx or DTC as a reason. Same goes for Novartis: Leaders mentioned DTC on the Oct. 28 call, but they didn’t correlate it to any earnings boost.

In fact, BioSpace reported the company’s CEO Vas Narasimhan said he doesn’t think the program will address the “root problem” of high drug prices, which he believes to be pharmacy benefit managers (PBMs), the 340B program, and “perhaps most importantly, G7 countries and related countries outside the US properly rewarding innovation and properly assessing the appropriate price for innovation,” he said on the call.

Community pharmacy impact. Mark Ey, SVP and COO at the National Community Pharmacists Association, told Healthcare Brew he doesn’t expect the rise of DTC to impact patients who use independent pharmacies because it’s mostly for patients who pay out of pocket.

According to Peterson-KFF Health System Tracker, out-of-pocket prescription drug spending saw a slight increase between 2020 and 2021 but is projected to decline 8% by 2031.

If DTC programs included insurance-covered drugs, that would make a bigger difference, he added, though it’s rare to find existing programs that do.

“Until you can remove the PBMs from the transaction, then there’s no room for the pharmaceutical manufacturers to be able to offer that product at a lower level,” Ey said.

PBMs have been accused of artificially inflating drug prices and steering patients toward more expensive medications.

Ordering drugs from multiple places can also create medication adherence challenges for patients, he added, as there’s more to keep track of—something patients wouldn’t generally encounter when dealing directly with a pharmacist.

Christie Boutte, SVP of reimbursement, innovation, and advocacy, and Chris Krese, SVP of congressional relations and communications at the National Association of Chain Drug Stores, said they believe it is important for patients to maintain their relationships with pharmacists as well.

“When you think about preventing harmful drug interactions, that is a core function of pharmacists all across communities in America, and that’s something that certainly needs to be preserved and remains essential to medication therapy,” Krese said.

Maia Anderson contributed reporting to this story.