Trump Says His Plan To Lower Drug Costs Is One Of The Most Important Impactful Things He's Ever Done

But Will It Ever Come To Anything?

Can you think of one good thing that Trump has ever done since slipping into the White House in 2017? I can’t— until today, when he signed a Bernie-type executive order to bring down the cost of drugs. Liz Whyte and Tarini Parti tried explaining the Truth Social tweet he put up Sunday afternoon. The goal, he said is “to implement a policy that ties U.S. drug prices to what other countries pay… He didn’t specify whether the order would apply to Medicare, Medicaid or other government programs. He said he would sign the order Monday.”

Trump knows what a big deal this is. He teased it out. “Hours before he announced the order, Trump posted: ‘My next TRUTH will be one of the most important and impactful I have ever issued. ENJOY!’” It could be… we’ll see what’s implemented and what kind of a real life impact it has. Some people are already saying the way he’s going about this is more likely to create severe shortages than lower prices that anyone can enjoy.

Americans often pay higher sticker prices for drugs than people in other countries. For example, the list price for diabetes medication Jardiance was $611 for a 30-day supply last year, according to health research nonprofit KFF, compared with $70 in Switzerland and $35 in Japan.

The White House recently weighed legislation instituting the most-favored-nation drug policy for Medicaid, which pharmaceutical executives estimated would cost their industry more than $1 trillion over the next decade and force some companies to withdraw from the insurance program for low-income Americans.

“Government price setting in any form is bad for American patients,” said Alex Schriver, senior vice president of Pharmaceutical Research and Manufacturers of America, a trade association representing major drug companies. “At a time when we are facing growing competition from China, policymakers should focus on fixing the flaws in the U.S. system, not importing failed policies from abroad.”

The idea to peg drug prices to those paid overseas isn’t a new one for Trump. His first administration introduced a regulation to do so for certain cancer drugs and others paid for by Medicare, but the effort was struck down by a court on procedural grounds, then abandoned by the Biden administration.

Pharmaceutical executives in recent days scrambled to defeat the Medicaid drug pricing proposal in Congress, and the bill paying for Trump’s tax cuts is no longer expected to contain it.

Trump hinted that the drug industry’s pleas had fallen on deaf ears in the White House. 

As the NY Times reported last night, “The proposal he described, which alone cannot shift federal policy, is what he calls a ‘most favored natio’” pricing model. Trump did not provide details about which type of insurance the plan would apply to or how many drugs it would target, but he indicated that the United States should pay the lowest price among its peer countries… Any such plan will most likely be subject to challenges in court, and it is not clear whether it will pass legal muster, especially without action by Congress… The pharmaceutical industry bitterly opposes the idea, which would almost certainly cut into its profits, and has been lobbying against it as discussions of the policy have regained steam in Washington in recent weeks. Companies have warned that such a policy would lead them to spend less on research, depriving patients of new medicines… Trump’s embrace of the idea sets him apart from most Republicans, who have tended to be skeptical of government price setting. Democratic lawmakers have proposed versions of the idea. Ameet Sarpatwari, an expert in pharmaceutical policy at Harvard Medical School, said that Trump was tapping into an idea that had ‘populist appeal.’”

Some people are already saying the way he’s going about this is more likely to create headlines than real savings. And that’s the Trump hallmark, isn’t it? Grand pronouncements, executive orders with vague enforcement mechanisms, splashy gestures engineered more for Truth Social clips than structural change. But what makes this one especially interesting is the target: Big Pharma.

Trump spent much of his 2016 campaign cozying up to pharmaceutical execs, promising them “a seat at the table” and tapping industry insiders to help shape his health policy. His first FDA commissioner, Scott Gottlieb, had deep ties to drug companies, and Trump’s tax policies delivered billions in windfalls to the largest firms in the industry. The Trump years saw little actual confrontation with pharma power; in fact, drug prices kept rising. So what’s with this sudden populist about-face?

It smells like smoke and mirrors— midterm elections pivot dressed in Bernie drag. Trump's a showman, not a reformer. He understands the optics of sounding like he’s battling greedy corporations but I don’t expect the pharma executives to panic just yet. Trump has danced this dance before, making noise about lowering prices only to back off when the industry pushed back. If this new executive order has real teeth, it would be a first. More likely, it’s performance politics, a gambit to paint himself as the champion of the little guy while quietly reassuring the donors in the back room that nothing will really change. If Trump’s actually serious this time, it would mark a remarkable betrayal of the industry that helped bankroll his political rise. But if history is any guide, Big Pharma has little to fear— and everything to gain— from a second Trump term being run by Russ Vought and Stephen Miller.