COLUMN: Trump Is Selling Pills, and Everyone Is Cheering

Mind-boggling figures

GLP-1 drugs for diabetes and obesity dominate the market. The pill form of Wegovy is priced as low as $149 per month—a first for an oral GLP-1 drug approved by the FDA for weight loss. Fertility treatments, which are often poorly covered by insurance, are seeing dramatic price drops: Gonal-F drops to $168 per pen, Cetrotide falls from $316 to $22.50, and Ovidrel plummets from $251 to $84. Inhalers such as Bevespi Aerosphere for COPD are dropping from $458 to $51. Eucrisa, a cream for atopic dermatitis, has seen its price drop by a factor of five, from $792 to $158. Lispro insulin is available starting at $25 per month.

These figures take my breath away. Truly. Because behind every price cut, there are lives. Women who dream of having a child and are spending their life savings on treatments. Diabetics who ration their insulin. Asthmatics who count their inhaler puffs. But here’s the problem: these “revolutionary” prices remain out of reach for millions of Americans. A hundred dollars a month is still too much when you’re earning minimum wage.

Pay Cash or Use Health Insurance

The website requires cash payment, excluding any use of health insurance. This requirement creates a dilemma for insured patients who could pay less through their coverage, especially after reaching their deductible. Experts from Boston University and Vanderbilt University point out that insurance copayments are often lower than TrumpRx prices, particularly for available generic drugs. The site itself advises users to check their insurance copayments. A recent agreement with Express Scripts, following a settlement with the Federal Trade Commission, now allows TrumpRx purchases to count toward deductibles—but subject to legislative or regulatory conditions.

This is where it gets perverse. They tell you, “Look at these incredible prices!” But they force you to pay cash. No insurance. So you, the insured patient, have to do the math. Compare prices. Become an expert in pharmaceutical mathematics. And what if you make a mistake? You end up paying more. Is that what a revolution looks like? Turning every patient into an accountant for their own survival?

What They Don’t Tell You

Several drugs announced in the initial agreements are not listed on the website. Merck’s Januvia, promised at $100, remains unavailable on the platform. The full details of the agreements between the administration and the manufacturers have never been made public. It is unclear whether these arrangements will survive Trump’s departure. The impact on Medicaid programs remains unclear. Some of the listed drugs are already available at the same price on GoodRx, such as Pfizer’s Duavee at $30.30. Experts are concerned about a possible reduction in investment in biotechnology innovation, particularly among small and medium-sized pharmaceutical companies.

The silences. It’s always in the silences that we find the truth. Which drugs are missing? Why? What secret agreements have been signed? What will happen in 2029 when Trump leaves? No one is answering. And in the meantime, we’re being asked to trust. To believe. To applaud. Sorry, but I don’t applaud in the dark.

When Obesity Becomes a Market

Obesity drugs dominate the TrumpRx offering. Novo Nordisk reveals that 30% of Wegovy prescriptions are filled through its NovoCare self-pay channel, and 90% of prescriptions for the new Wegovy pill come from this platform. Eli Lilly reports that one-third of new patients taking brand-name anti-obesity drugs choose to purchase Zepbound out-of-pocket. More than one million patients used LillyDirect in 2025. This popularity stems from the lack of insurance coverage for these treatments, forcing patients to pay out of pocket. Analysts doubt that other drug categories will see the same success.

Obesity. That’s the real jackpot. Not heart disease. Not cancer. Obesity. Because insurance doesn’t cover it. Because people are desperate. Because you can sell them a dream for $300 a month. And Trump figured that out. He’s riding this wave. He’s capitalizing on shame, on despair, on the visceral need to conform to standards. It’s commercial genius. But is it public health?

When the Solution Creates New Problems

The expansion of direct-to-consumer sales channels could prompt insurers to remove certain drugs from their coverage, arguing that patients now have direct access. Patients with high deductibles might benefit from TrumpRx, but those with low deductibles would likely pay less through their insurance. Professor Stacie Dusetzina of Vanderbilt points out that research shows that once monthly costs exceed $100, many patients stop taking their medications. Trump’s previous threats to investigate anti-competitive practices by pharmaceutical companies and to use the Federal Food, Drug, and Cosmetic Act to review drug safety could have long-term repercussions.

The consequences. Always the consequences. We launch an initiative, make promises, sign agreements. And then what? Insurers rub their hands together: “Why cover this drug when it’s available on TrumpRx?” Patients find themselves stuck. Again. Always. It’s a game of ping-pong where the ball is your health. And no one wins except those holding the paddles.

Elections and Communication Strategy

Trump views TrumpRx as a major pillar of his strategy to alleviate voters’ anxiety about the cost of living—a factor that is weighing on his approval ratings and worrying Republican candidates ahead of the November 2026 midterm elections. The initiative is part of his broader healthcare plan announced on January 15, 2026, aimed at codifying the savings from the MFN program, reducing insurance premiums, and maximizing price transparency. In December 2025, the administration negotiated an agreement with the United Kingdom to increase the net price of new prescription drugs by 25%, forcing the British to “pay their fair share.” The president is growing increasingly enthusiastic, making a flurry of announcements at the White House.

Politics. It’s all politics. Trump isn’t launching TrumpRx to save lives. He’s launching it to save his political skin. To polish his image. To ensure Republicans keep control of Congress. And you know what? It’s working. People see the big numbers, the dramatic reductions, and they forget to ask the real questions. They forget to look behind the curtain. It’s theater. The great American spectacle. And we’re all in the audience, applauding.

What the Experts Say

Professor Rena Conti of Boston University states that “TrumpRx could support access and affordability for a very small number of people.” Joey Mattingly of the University of Utah points out that consumers will need to do thorough research to determine whether TrumpRx is right for them. Mariana Socal of Johns Hopkins warns of unintended consequences, including the risk that insurers might stop covering drugs available on the platform. Evan Seigerman, an analyst at BMO Capital Markets, doubts that patients will be as eager to pay out of pocket for blood thinners as they are for weight-loss drugs. Opinions remain mixed on the actual long-term impact.

Listen to the experts. Not the politicians. Not the press releases. The experts. Those who have been studying public health for decades. Those who understand complex systems. And what do they say? That TrumpRx will help “a very small number of people.” Not millions. A very small number. So why all the fuss? Why the spectacle? Because perception matters more than reality. Because a headline is better than a real solution.

Between Hope and Disillusionment

The launch of TrumpRx on February 5, 2026, marks a turning point in how Americans access prescription drugs. The announced price cuts are real, and the potential savings are significant for some patients. But the reality is more nuanced than the promises. The requirement to pay out-of-pocket excludes many insured individuals. The most popular drugs on the platform are those not covered by insurance. The details of the agreements remain unclear. The program’s future beyond 2029 remains uncertain. Experts warn that the impact will be limited. And in the meantime, millions of Americans continue to choose between their medications and their rent, between their health and their financial survival. TrumpRx is not the revolution that was promised. It is one more option in a system that is already broken.

I wanted to believe in it. I really did. I wanted to see TrumpRx as a glimmer of hope, the beginning of a solution, something that would truly be a game-changer. But the more I dig, the more I read, the more I understand… and the more empty I feel. Because it’s not a revolution. It’s a Band-Aid on a bleeding wound. It’s political marketing disguised as health policy. And the worst part? It’s going to work. People will cheer. The media will run with it. Trump will strut around. And in six months, in a year, when the dust settles, we’ll realize we’ve been duped yet again. That American healthcare remains a privilege, not a right. That prices are falling for a few while millions continue to suffer. I’m tired of these empty promises. Tired of these illusions. Tired of seeing healthcare turned into a spectacle. But I’ll keep writing. I’ll keep speaking out. I’ll keep hoping that one day, perhaps, we’ll stop selling pills and start treating people.

Signed, Jacques Provost