President Donald Trump has promoted TrumpRx.gov as evidence of a drive to push U.S. prescription drug prices from the highest in the world to the lowest. But a line-by-line comparison of publicly available figures shows the web portal does not uniformly deliver prices lower than those the United Kingdom’s state-funded National Health Service pays.
The TrumpRx website, launched in January, is part of the administration’s most-favored-nation arrangements with 16 drugmakers intended to lower what cash-paying Americans might pay for medicines to levels comparable with other developed countries. The U.K. has its own understanding with the United States that avoided U.S. drug tariffs in return for greater pharmaceutical spending.
Yet about one-third of the 54 drugs listed on TrumpRx carry prices that are lower in the U.K., according to a Reuters review of the two governments’ publicly posted figures. Among those with lower U.K. payouts are Pfizer’s arthritis medication Xeljanz, AstraZeneca’s diabetes treatment Farxiga and GSK’s inhalers for lung conditions. In these cases, the U.K. payouts were between 67% and 82% less than the prices shown on TrumpRx.
The president has touted the site as proof of sweeping price reductions, asserting that some medicines are now “300% to 600%” cheaper. That math is not possible as stated. Healthcare affordability is a salient political issue for the administration as Republicans work to hold their congressional majority in the November elections.
Independent commentary has been skeptical of how broadly the TrumpRx listings translate into lower costs for most patients. Wayne Winegarden, a medical economist at the Pacific Research Institute, described TrumpRx as "a big... really expensive coupon book," noting that it primarily reflects direct-to-consumer cash prices or links to manufacturer-run purchasing pages rather than the prices most Americans with private or government insurance actually incur at the pharmacy counter.
TrumpRx reflects cash prices available to consumers who pay out of pocket. That differs from typical insured patients’ costs, which are driven by flat-fee copays or coinsurance based on a percentage of a drug’s cost. The site, and the most-favored-nation deals that underpin it, do not change insurer formularies or negotiated reimbursement rates for the majority of Americans.
Drugmakers have signaled varying expectations about the deals’ effects on revenue. Some firms, including Swiss drugmakers named in public statements, have indicated the arrangements would be immaterial to earnings. By contrast, Novo Nordisk warned that much lower prices for obesity medicines could compress profitability, and in one disclosure said sales and profit could fall as much as 13% in 2026 as a result of the negotiated prices. Johnson & Johnson estimated an impact measured in "hundreds of millions of dollars."
There is a concentration of large savings among high-demand obesity drugs. Reuters compared what pharmacies are paid by Britain’s National Health Service, whose payouts are updated monthly, against the prices shown on TrumpRx for eight companies participating in the program so far. The most notable reductions were for GLP-1 injectable obesity medicines: Eli Lilly’s Zepbound and Novo’s Wegovy.
Both companies agreed to November deals under which the GLP-1 injections would be offered at average U.S. prices ranging between $149 and $350 a month, down from initial list prices that exceeded $1,000 per month. Those negotiated rates represent substantial reductions for patients paying cash and are among the largest discounts visible on TrumpRx.
Fertility treatments also saw notable cuts. EMD Serono, the U.S. and Canadian healthcare business of Germany’s Merck KGaA, said its TrumpRx pricing reflects U.S.-specific negotiations rather than cross-border price comparisons. The company said TrumpRx provides an 84% discount from list prices for three U.S. fertility drugs that are typically used together in an in vitro fertilization protocol.
Drugmakers have pointed out limits of cross-country price comparisons. Novo Nordisk cautioned that U.S.-to-EU comparisons often overlook differences in approved doses, indications, delivery devices, and the interplay of distinct healthcare systems. That, the company said, complicates one-to-one price equivalence.
Other medicines already facing generic competition also showed cheaper prices overseas. Reuters noted that some generics, such as Pfizer’s steroid Medrol and the cholesterol drug Lopid, are less expensive in the U.K. than the branded alternatives reflected on TrumpRx.
Experts also emphasize the voluntary and non-binding nature of the TrumpRx listings and the related most-favored-nation deals. Aaron Kesselheim, a professor of medicine at Harvard Medical School, said the approach lacks enforcement mechanisms and does not broadly address structural factors that produce high drug prices. "I’m not surprised that the end result is something that is not workable for the vast, vast majority of patients," Kesselheim said.
Analysts expect varied financial impacts across the pharmaceutical sector. Some companies with limited exposure to government-purchased volumes indicated negligible effects, while others with greater government program sales face larger hits. BMO Capital Markets healthcare analyst Evan Seigerman described many of the products included in the most-favored-nation deals as older therapies nearing the end of their commercial life cycle, often with alternative treatments available, which can limit financial exposure for large diversified firms.
Philip Sclafani, head of life sciences at PWC U.S., said the deal outcomes will depend on how much of a company’s revenue is tied to government versus commercial channels. "Those that have more business in the government... they’re seeing bigger impacts in general," he said.
Operationally, the U.K. sets the prices it pays for medicines through a combination of cost-control agreements and assessments. In England, patients pay a standard prescription charge of 9.90 pounds, equal to $13.19 at the exchange rate cited in the comparison. Prescriptions are free in Scotland, Wales and Northern Ireland. Reuters used the U.K. payout figures updated monthly by the NHS to compare with the TrumpRx listings.
Methodological note
The Reuters comparison matched publicly posted U.K. pharmacy payouts against prices listed on TrumpRx for each eligible medicine from participating companies. The analysis covered 54 medicines shown on TrumpRx and used NHS data that are updated monthly. Currency conversions referenced the rate of $1 = 0.7505 pounds as cited in the material reviewed.
Where this matters
- Consumers paying cash for medicines may see substantial savings on certain products, especially GLP-1 obesity drugs and some fertility treatments.
- The pharmaceutical sector faces mixed earnings pressure depending on the mix of government and commercial sales for each company.
- Insurance-covered patients are less likely to see immediate out-of-pocket benefits, since insured costs are driven by copays and coinsurance rather than cash list prices.