TrumpRx.gov is a direct-to-consumer (DTC) website run by the federal government that allows patients to pay cash prices for certain prescription drugs. The website is part of a broader Trump administration initiative focused on bringing American drug prices closer to the prices paid in other developed countries. This is being referred to as most-favored-nation (MFN) drug pricing.
While the government will not purchase and sell drugs directly, the TrumpRx website will redirect patients to DTC websites of drug manufacturers that have entered agreements with TrumpRx. The website has already been launched, and patients can begin purchasing drugs at TrumpRx prices by early 2026.
For employers operating self-insured health plans, the implications are meaningful, particularly for GLP-1 therapies, which continue to drive significant pharmacy spend and member interest.
Who is Negotiating Drug Prices and Why?
Major drug manufacturers are voluntarily negotiating with the Trump administration to avoid tariffs on their branded products. In late September, the administration announced 100% tariffs on branded or patented imported drugs that were set to take effect on October 1, 2025. The tariffs were ultimately delayed while the administration negotiated with manufacturers willing to voluntarily lower drug prices.
As part of these agreements, the manufacturers committed to make certain drugs available at MFN prices via TrumpRx, offer MFN pricing to Medicaid, launch new drugs at MFN prices and invest heavily in domestic drug manufacturing. In return, manufacturers will receive a three-year grace period from the brand tariffs. The specific terms of these pricing agreements have been deemed confidential and have not been publicly disclosed.
As of December 2025, the following manufacturers have entered into agreements to offer certain drugs on TrumpRx at discounted prices:
- Pfizer
- Amgen
- AstraZeneca
- Eli Lilly
- Novo Nordisk
- EMD Sorono
What is New for GLP-1s?
Manufacturers participating in TrumpRx have announced substantially reduced cash prices for several GLP-1 products. Early announcements include:
- Starting doses as low as $199 per month
- Maintenance doses priced at $449 - $499 per month
- New oral GLP-1s expected to enter market below traditional injectable pricing
These price reductions primarily target individuals who choose to pay out-of-pocket instead of relying on insurance coverage. As a result, TrumpRx will expand an already growing parallel market in which members compare plan pricing and access requirements to simpler cash-paying alternatives.
While these programs may make GLP-1 therapies more financially attainable for individuals whose plans exclude weight loss medications, the structure of TrumpRx does not integrate with deductibles, out-of-pocket accumulators or commercial cost-sharing rules.
How Does This Impact Employer-Sponsored Coverage?
At this time, TrumpRx pricing is only available to cash-paying patients who are not using their health benefit plans. Some manufacturers’ press releases have confirmed that the agreements do not apply to commercial market pricing. Thus, the patients most likely to benefit from TrumpRx are uninsured patients and patients seeking access to drugs not covered by their plan. Any patient spend through the website will not count toward a patient’s deductible or maximum out-of-pocket.
DTC programs are not a new concept, and several manufacturers have launched DTC websites over the last few years. However, these options typically only include a narrow subset of drugs and may not result in a lower net cost. For most patients, the drugs will still be cheapest when accessed through the benefit plan.
Still, the public availability of these discounted prices will serve as new benchmarks that plan sponsors expect in the commercial market. Some manufacturers have committed to offering lower prices to the commercial market and decreasing the list prices of newly launched drugs, but the impact of these commitments will depend heavily on the specific scope of these agreements, which have yet to be released.
Looking Ahead
TrumpRx is unlikely to meaningfully reduce employer pharmacy costs in the short term, and there is no indication that government-negotiated pricing will extend to commercial
plans. However, the increasing visibility of lower cash prices may influence how members view the value of their pharmacy coverage and could lead to more questions about access and affordability.
As members compare plan benefits with low cash prices, some may elect to bypass their pharmacy benefit entirely. This reduces adjudicated claim volume, weakens the reliability of plan forecasting and directly impacts rebate capture. Employers who rely on minimum rebate guarantees or pharmacy performance guarantees could see variability in expected financial results.
Increases in off-benefit utilization reduce clinical oversight. When prescriptions are filled outside of the pharmacy benefit, employers and PBMs lose visibility into drug-drug interactions, duplicate therapy, inappropriate titration or co-prescribing patterns. The growth of telehealth prescribing, often occurring without coordination with a member’s care team, further amplifies these risks. The promotion of discounted cash pricing increases the likelihood that members may unknowingly obtain non-FDA-approved compounded drugs or medications from unfamiliar dispensing channels.
By incorporating these dynamics into financial planning, communication efforts and future benefit plan design discussions, employers can better prepare for how TrumpRx may shape member expectations and overall plan performance in 2026.
These policies have not been finalized, and updates continue to emerge as additional manufacturers negotiate with the administration. Tariffs may be a factor for manufacturers unable to reach an agreement. We will continue to stay on top of the updates.
Disclaimer: Materials are solely for informational purposes as an educational resource. Please contact counsel to obtain advice with respect to any specific issue
