White House expands TrumpRx to generics

President Donald Trump said on May 18 that his administration added more than 600 generic medicines to TrumpRx.gov, broadening a White House-backed direct-to-consumer drug site that had launched in February with selected branded products. The White House said the expansion increased the number of products on the platform by nearly seven times and framed the move as part of its effort to lower out-of-pocket prescription costs. The same day, the U.S. Supreme Court declined to hear separate appeals from six drugmakers challenging Medicare’s drug price negotiation program. Healthcare Finance News reported the rejected appeals were brought by AstraZeneca, Janssen, Bristol Myers Squibb, Novo Nordisk, Boehringer Ingelheim and Novartis. Taken together, the two developments show the administration and the courts leaving in place two different channels of price pressure: cash-pay discounts through TrumpRx.gov and negotiated reimbursement under Medicare. (cnbc.com) That characterization is an inference based on the White House expansion and the court’s refusal to take up the manufacturers’ challenge. (healthcarefinancenews.com) ### How much bigger did TrumpRx.gov get? Trump said on May 18 that the site was adding more than 600 generic drugs. CNBC reported that the move raised the number of products on TrumpRx.gov by nearly seven times from the earlier lineup, which had centered on branded medicines from manufacturers that agreed to lower prices. The White House fact sheet said the expanded site was meant to bring “transparency and choice on everyday medicines.” The administration did not present the program as an insurance benefit; earlier White House materials and CNBC’s February launch report described TrumpRx.gov as a direct-to-consumer channel aimed at patients paying cash, with savings tied to most-favored-nation pricing deals. (healthcarefinancenews.com) (cnbc.com) ### What was on the site before generics were added? TrumpRx.gov launched on February 5 with drugs from the first five manufacturers to reach pricing deals with the administration: AstraZeneca, Eli Lilly, EMD Serono, Novo Nordisk and Pfizer, according to the White House. The launch materials said patients would be able to access discounts on dozens of high-cost brand-name medicines. (whitehouse.gov) CNBC reported in February that the site’s early offerings included branded drugs and that the biggest savings were expected for some patients willing to forgo insurance and pay cash. Later White House materials highlighted obesity drugs and fertility medicines as examples of products expected to generate patient savings through the direct channel. (whitehouse.gov) ### Which drugmakers lost at the Supreme Court? The Supreme Court on May 18 declined to hear appeals tied to the Medicare Drug Price Negotiation Program. Healthcare Finance News said the justices refused separate petitions from AstraZeneca, Janssen, Bristol Myers Squibb, Novo Nordisk, Boehringer Ingelheim and Novartis. (cnbc.com) Supreme Court docket materials show Novo Nordisk had asked the justices to review whether the program violated constitutional limits, including arguments related to delegation and judicial review. The court’s refusal means lower-court rulings against the challengers remain in place. ### What does this leave in place for drug pricing? (healthcarefinancenews.com) The Medicare negotiation program remains intact after the court’s action, and TrumpRx.gov remains a voluntary direct-sales channel backed by White House pricing agreements. The White House said last week that its broader most-favored-nation framework would also require participating manufacturers to make existing drugs available to state Medicaid programs at those prices. (supremecourt.gov) White House research published in May said discounted prices through TrumpRx.gov were expected to generate savings for drugs commonly bought outside insurance, including GLP-1 obesity medicines and fertility treatments. Those materials estimated uninsured GLP-1 users could save about $3,000 a year and couples undergoing in-vitro fertilization could save more than $6,000. (healthcarefinancenews.com) ### What comes next for manufacturers and patients? TrumpRx.gov is already live, and the White House fact sheet dated May 18 says the generic-drug expansion is in effect now. Patients can review the updated list through the administration’s TrumpRx.gov materials, while the Medicare negotiation cases will proceed under existing lower-court outcomes unless Congress or regulators change the program. (whitehouse.gov 1) (whitehouse.gov 2)