TrumpRx: Background and Implementation

TrumpRx: Background and Implementation

TrumpRx: Background and Implementation

July 31, 2026 (IF13281)

Introduction

On February 5, 2026, the Trump Administration officially launched TrumpRx, a website that compiles discounts on brand-name and generic drugs through partnerships with drug manufacturers and direct-to-consumer (DTC) pharmacies. Since the launch, Congress has examined the website's operations, the types of drugs available, consumer access to the advertised prices, and the impact on prescription drug affordability. This In Focus describes prescription drug coverage and mechanisms to reduce out-of-pocket (OOP) costs, summarizes TrumpRx's operations, characterizes the drugs currently listed on TrumpRx, explains consumer access to discounted drug prices, and discusses estimates of the potential savings available through the website.

Prescription Drug Coverage and Spending

In 2024, most Americans had some form of prescription drug coverage through Medicare, Medicaid, the Veteran's Health Administration, or a private health insurance plan offered through their employer. In general, each prescription drug plan has a formulary (a list of covered drugs) that the plan will cover, and enrollees pay some amount of OOP costs to access covered drugs. Many plans have a deductible, which is an amount that enrollees are required to pay for their prescription drugs and other covered benefits before their insurance plan provides coverage. After any applicable deductible has been met, enrollees may also be required to pay cost-sharing in the form of copayments or coinsurance when they fill a prescription.

Recent trends in OOP spending vary by payer and type of drug. From 2024 to 2025, OOP costs increased for individuals who were privately insured, enrolled in Medicaid, or using cash or assistance to pay for drugs. Enrollees' OOP costs fell 2.2% in aggregate for Medicare beneficiaries during that same time period. A recent KFF survey found that six in 10 adults have concerns about affording their prescription drugs.

Drug Coupons and Direct-to-Consumer Pharmacies

In recent years, drug manufacturers and other prescription drug market participants have explored mechanisms that can lower consumers' OOP costs and boost product uptake. One such tool has been manufacturer coupons. Coupons for specific drugs are available in a variety of formats, such as a discount offer downloaded from a manufacturer's website, or a discount card that can be used at pharmacy checkout. The coupon may come directly from the manufacturer or may be available through a manufacturer-contracted vendor. The coupon may require consumers to go outside of their prescription drug plan, or it may be used as a secondary payment to offset patient cost-sharing after any initial plan payment has been made. IQVIA found that approximately one in five patients used at least one discount card in 2021.

Consumers are also increasingly able to purchase drugs from direct-to-consumer pharmacies without using their prescription drug coverage. In some cases, these DTC pharmacies are operated by retailers such as Amazon, Walmart, and Costco. Some DTC pharmacies may focus on specific products, such as Cost Plus Drugs, which sells and manufactures generic drugs. Others are operated by pharmaceutical manufacturers, such as Eli Lilly's, which offers both DTC pharmacy and telehealth services through an online platform.

Individuals with prescription drug coverage may not be able to access discounts through DTC services while using their insurance coverage. Private health insurance plans increasingly use copay accumulator programs that exclude manufacturer assistance such as copay coupons from counting toward an enrollee's deductible or OOP maximum. Consumers are also limited in the use of copayment coupons in conjunction with federal health care programs due to federal anti-kickback statutes. In January 2026, The Department of Health and Human Services (HHS) issued guidance clarifying the circumstances under which DTC sales to federal health care program enrollees violate anti-kickback statutes. HHS also issued a Request for Information in January 2026 seeking input on whether the increasing prevalence of DTC platforms, including TrumpRx, requires modifications either to regulations under the anti-kickback statutes or to the current exceptions to the civil monetary penalty provision prohibiting inducements to beneficiaries.

TrumpRx

On May 12, 2025, the Trump Administration issued Executive Order (EO) 14297, Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients. Section 4 of the EO directs the HHS Secretary to "facilitate direct-to-consumer purchasing programs for pharmaceutical manufacturers that sell their products to American patients at the most-favored-nation price."

In September 2025, the Trump Administration announced that an online platform named TrumpRx was in development, and that Pfizer would participate. Over the next few months, additional manufacturers announced that they would also list their drugs on TrumpRx. As of May 5, 2026, 17 drug manufacturers had TrumpRx agreements in place. The administrator of the Centers for Medicare & Medicaid services has stated that the agreements will expire at the end of President Trump's term.

Figure 1

. TrumpRx Timeline (2025-2026)

Figure is interactive in HTML report version.

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Source: CRS examination of executive branch press releases, interviews, and bulletins, supplemented by news searches.

Notes: This timeline is not meant to be comprehensive and is current as of the publication date of this product.

TrumpRx Website Launch and Management

During the fall of 2025, the TrumpRx website went live but did not list any available drugs. The official launch of TrumpRx occurred on February 5, 2026. TrumpRx is designed and operated by the National Design Studio (NDS). The NDS, under the Executive Office of the President, was created by EO 14338, Improving Our Nation Through Better Design, on August 21, 2025. NDS is a temporary organization under 5 U.S.C. §3161, led by a former member of the Department of Government Efficiency. TrumpRx is integrated with GoodRx, an existing drug coupon aggregator.

Drugs Available on TrumpRx

Drugs from a variety of manufacturers, including Merck, Pfizer, Novartis, NovoNordisk, Genentech, and Johnson & Johnson, are listed on TrumpRx. The products available range from inhalers, to insulin products, to anticancer medications, and several medications are related to weight loss and fertility treatment. When TrumpRx first launched, discounted prices for 40 drugs were available. The number of drugs has fluctuated but generally increased since then, with more than 50 drugs available in March 2026 and 87 drugs available in late April 2026. In May 2026, a partnership with Cost Plus Drugs, Amazon Pharmacy, and GoodRx was announced, which led to approximately 600 generic drugs being added to the website. In early June 2026, another 160 generic drugs were added. Many of the brand-name drugs available have generic alternatives or are nearing the end of their exclusivity period. The available drugs also overlap with drugs chosen for the Medicare Drug Price Negotiation Program. Prices for each drug can vary according to formulation, dosage strength, and quantity supplied.

Consumer Access to TrumpRx Prices

TrumpRx connects consumers with drug coupons and DTC pharmacies but is not itself a DTC platform. The path that consumers take to access TrumpRx prices varies depending on the drug selected. In some cases, consumers are directed to a DTC pharmacy partner to fill their prescription. For example, in the case of Mayzent, a drug for the treatment of multiple sclerosis, consumers are directed to a website for ASPN pharmacies, which dispenses the drug to eligible patients. In other cases, such as the fertility medication Cetrorelix (Cetrotide), the price is accessible via a coupon that can be directly downloaded or printed and then used at participating specialty pharmacies.

Estimates of Consumer Savings Through TrumpRx

Due to the limitations consumers may face when using drug discounts with prescription drug coverage, consumers who are uninsured or go outside of their coverage are most likely to achieve savings using TrumpRx. The TrumpRx website notifies prospective consumers that their copays may be lower than the price listed on the website. Patients may go outside of their prescription drug coverage when a drug is not on the formulary for the plan, which may be the case for drugs for weight loss or fertility treatment. The Council of Economic Advisors estimated that using TrumpRx may result in savings for patients outside of their prescription drug coverage of $3,000 per year per patient by 2028 for weight loss drugs and $2,191 per in vitro fertilization cycle.

While brand-name drugs advertise "Presidential Deals," many of the generic drugs available on TrumpRx are offered through the partnerships with DTC pharmacies and advertise "Standard Deals." Although consumers may access savings on the generic drugs offered through these arrangements, estimates of savings vary. It is also unclear how the international price comparisons displayed on TrumpRx are being determined.

Congressional Response

Following the announcement of TrumpRx, congressional members and committees have issued press releases, reports examining the site's impact, and letters to HHS. The executive branch has called on Congress to codify the Most-Favored-Nation (MFN) agreements and TrumpRx; no legislation on this topic has been introduced at this time. Legislation (S. 4355) has been introduced that would require analysis of these drug agreements. Since the MFN deals and the TrumpRx website are relatively new and additional drugs are still being added, evaluative research is currently limited.