Here are the Pfizer Drugs to be Offered Through TrumpRx

Launched with fanfare at the White House, the deal with Pfizer to provide discounts to Medicaid through the Most Favored Nation pricing effort may not have a big impact on lowering drug prices, and any impact will not likely be seen in the short term, industry leaders say. President Donald Trump, along with Pfizer chairman and CEO Albert Bourla, announced the deal at a press conference on Tuesday. The deal requires Pfizer to offer medications at a discount and invest in production in the United States.

Pfizer is only offering six products that can be accessed through TrumpRx.gov when the website goes live sometime next year (see Table below), including some that are very high priced. Even with a discount, these therapies would be out of reach for cash-paying patients.

For example, Xeljanz (tofacitinib), an oral medication for rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis, will be available at a 40% discount to patients who purchase directly. Its current list price, however, is $6,073.14. Zavzpret (zavegepant), which is used to treat migraines, will be offered at a 50% discount, but its list price is $1,130.

Related: Trump’s Favored Nation Drug Pricing is Unworkable, Critics Say

Trump had announced the return of the Most Favored Nation pricing effort in the spring. At the time, pharmaceutical industry leaders and policy experts said Most Favored Pricing is flawed and unworkable.

Milena Sullivan

Pfizer’s move sets a baseline, but significant questions remain about the initiative, Milena Sullivan, practice director at Avalere Health, said in an interview. “We could see dramatic shifts in how the market operates going forward, but not with a single policy decision. I think this will be a series of evolutions that are changing incentives and priorities, rather than a one-off overnight change,” she said.

How other companies respond remains to be seen. At the press conference, officials mentioned that Lilly was close to finalizing its commitment. But Sullivan said that there will likely be significant differences in how companies respond, “so it remains unclear what this means for patients and for the broader drug pricing system.

“Chronic disease medications are better suited for direct-to-consumer models than complex specialty medications, suggesting responses will vary significantly based on each company’s product portfolio,” Sullivan said. “This is the first of many steps to address drug pricing on different fronts, and there will be more activity around some products where we don’t see voluntary action from manufacturers,” Sullivan said.

The initiative also raises questions about the future role of pharmacy benefit managers (PBMs), which have faced increasing scrutiny. By enabling manufacturers to bring discounts closer to the patient while bypassing intermediaries, these direct-to-consumer programs could eventually shift traditional business models throughout the pharmaceutical supply chain.

The Pharmaceutical Research and Manufacturers of America (PhRMA), the trade organization for pharmaceutical companies, issued a statement that the deal doesn’t address the big discounts that “PBMs get on medicines while charging patients full price. Hospitals abuse the 340B program to mark up drug prices by 700% or more. Addressing these abusive practices would dramatically lower drug prices for U.S. patients,” PhRMA President and CEO Stephen J. Ubl said in the statement.

Minimal Impact on Drug Costs

Benjamin N. Rome, M.D.

Some industry watchers say the impact of Pfizer’s announcement could be minimal for several reasons. A lot remains unclear about the impact on Medicaid programs, Elizabeth Williams, one of KFF’s Medicaid policy experts, told Managed Healthcare Executive. “Medicaid drug pricing is complicated, so there is not much we can say about the Medicaid drug pricing implications at this time. While the changes announced could potentially impact state and federal spending on Medicaid prescription drugs, they are not likely to lower prescription drug costs for Medicaid enrollees, since they already pay little to no copays.”

Without knowing the details, Pfizer’s MFN announcement, which is limited to Medicaid, will not likely make much of a difference for patients or for taxpayers, Benjamin N. Rome, M.D., M.P.H., a faculty member of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston, told Managed Healthcare Executive.

“The announcement was a lot of pomp and circumstance and not a lot of substance,” he said. “In terms of the direct-to-consumer model, this doesn’t really help patients, since most will not be able to afford to buy them even at the discounted prices. Patients are already paying hundreds or thousands of dollars a month for health insurance premiums. They cannot be expected to purchase their brand-name drugs in addition to those insurance costs.”

So, what does Pfizer get from participating? A three-year reprieve from possible tariffs. Bourla said during the press conference the agreement ensures that the company’s products will not be subject to tariffs as part of the deal with the Administration. Tariffs, he said, create an uncertainty for the industry, substantially reduce the company’s valuations, and create concerns for the company’s ability to invest.

“Because of this uncertainty, it was what was holding people from investing in the pharmaceutical industry, which resulted in a significant reduction of our multiples. Our multiples are at historical lows. Well, now we have clarity about what the framework for the U.S. price is, and we will abide by that. Going forward, this is how things will be priced in the U.S. and the world,” Bourla said during yesterday’s press conference.

During the three-year grace period, Pfizer agreed to begin producing drugs in the United States. The company plans to invest $70 billion in manufacturing and research in the United States over the next few years. In a news release, Pfizer executives said this investment builds upon the company’s more than $83 billion investment in American biotech innovation from 2018 to 2024. Pfizer plans to focus on the development of next-generation therapies, especially in cancer, obesity, vaccines, and inflammation and immunology.