Lisinopril

Starting Monday, TrumpRx.gov started to separately list common generic medications like lisinopril to lower high blood pressure and the ubiquitous diabetes drug metformin. With questions already swirling about the actual affordability impact of the government’s drug purchasing portal, TrumpRx, the White House is updating the platform to address a key gap in the medicines it lists, albeit with a number of caveats remaining. The expansion of TrumpRx.gov, announced by President Donald Trump on Monday, adds more than 600 generic medicines to the platform. The site allows patients to compare non-insurance prices for certain medications and links to other direct-to-consumer purchasing platforms, including online pharmacies and those operated by drug manufacturers. When the website launched near the top of the year, TrumpRx initially included only select branded pharmaceuticals that had been subject to price reductions under the Trump administration’s most favored nation agenda, which broadly seeks to align high U.S. drug prices with the lowest prices paid in certain high-income comparator nations. Now, the platform will separately list common generic medications like lisinopril to lower high blood pressure and the ubiquitous diabetes drug metformin, as well as the cholesterol medication atorvastatin and blood thinner clopidogrel, according to a White House fact sheet. The inclusion of copycat medicines on the government-run purchasing portal fills a significant gap that was left with TrumpRx’s debut earlier this year, with the FDA estimating that generic drugs make up some 9 out of 10 prescriptions filled in the U.S. As has been the case since the site’s launch, TrumpRx.gov won’t sell the generic medications to patients directly— instead, allowing them to “compare the best cash prices available to them at their local pharmacies,” plus weigh delivery options through various private pharmacy programs. The White House noted that it has integrated discounts offered through online medication channels like Amazon Pharmacy, GoodRx and Mark Cuban’s Cost Plus Drugs into the website, as well. While the update will include “some of the most popular and commonly-used everyday medications,” per the fact sheet, TrumpRx will omit controlled substances—which would include, for instance, stimulant-based ADHD medications—as well as those with FDA-mandated risk evaluation and mitigation strategies (REMS) and those “not commonly offered through direct-to-consumer channels.”TrumpRx forms a key pillar of the President’s drug pricing and broader pharmaceutical policy agenda, with Trump calling on 17 of the world’s biggest pharmas last year to embrace direct-to-consumer sales channels—among other price-lowering demands—in his most-favored-nation call to action.  Coupled with the cudgel of the second Trump administration’s pharmaceutical import tariffs, the White House has been able to extract pricing concessions and U.S. investment pledges from many of the industry’s most prominent drugmakers, including Novo Nordisk, Eli Lilly, Gilead, Roche and, most recently, Regeneron. Under those agreements, 17 Big Pharmas have also made pledges to register certain products at discounted prices through the TrumpRx portal, with Regeneron offering up its cholesterol-lowering drug Praluent in its case. Other branded medicines featured on the government site include Novo’s GLP-1 blockbusters Ozempic and Wegovy, fertility meds from Merck KGaA’s EMD Serono, AstraZeneca inhalers and Pfizer’s eczema ointment Eucrisa, to name just a few examples. Even before its launch, TrumpRx was the target of controversy, attracting scrutiny from Democratic Sens. Dick Durbin of Illinois, Peter Welch of Vermont and Elizabeth Warren of Massachusetts, who warned the HHS’ Office of Inspector General in January that the website could violate federal anti-kickback laws. Since then, the site’s true impact on the affordability of medicines for American patients has been further drawn into question.  In March, a report from The New York Times and German news organizations Süddeutsche Zeitung, NDR and WDR found that drug prices in Germany remained lower than many listed on TrumpRx in a side-by-side comparison. At the time, the report also flagged that while the TrumpRx price for Novo’s obesity med Wegovy was lower than Canada’s, it remained higher on the government site than that in seven other countries, including Germany, the U.K. and Japan. On Tuesday, Reuters separately reported that, based on its own comparison of publicly available prices, the costs recorded on TrumpRx are, in many instances, not lower than those paid in the U.K.