TrumpRx adds 600 generics and it’s a big deal

ENTER GENERICS

Hundreds of generic drugs have now been added to TrumpRx.gov. Prior to this week, the platform only included select branded drugs, but now 600 generic medications from the Mark Cuban Cost Plus Drug Company, Amazon Pharmacy, and GoodRx have been integrated into the website.

Since the launch of TrumpRx.gov, people have questioned its “impact on the affordability of medicines for American patients,” and there’s been no shortage of articles arguing that “TrumpRx isn’t doing much for drug prices”. I understand the criticisms, especially since these prices exist outside of insurance and there are real limitations and challenges that come with that model. Many have also critiqued that “the platform offers discount coupons that are readily available elsewhere” so it’s really about packaging existing options rather than meaningfully lowering drug prices.

Even with those caveats, I think this latest addition is a big deal.

SO WHAT

TrumpRx’s expansion into generics matters not because the prices are new, but because the generic drug industry is intensely competitive and runs on market share capture. If TrumpRx can increase the number of people that get pushed to low-cost generic offerings, that creates more demand at places like the Mark Cuban Cost Plus Drug Company, and more demand allows for volume price discounts from the generic manufacturer, and lower prices from the manufacturer leads to lower prices for the patient, and lower prices take market share.

The even bigger gain may be from the highly visible price comparisons between Amazon Pharmacy and the Mark Cuban Cost Plus Drug Company.   

If you look up lisinopril on TrumpRx, you can quickly see that Amazon Pharmacy sells lisinopril for $5.90 (for a 30 count of 2.5mg) whereas the Mark Cuban Cost Plus Drug Company sells it for $10.53. The two prices are presented right next to each other—actually the TrumpRx website lists whichever option is cheaper first.

If you look up sacubitril-valsartan, the Mark Cuban Cost Plus Drug Company wins by selling it for $14.29 (for a 30 count of 24/26 mg) whereas Amazon sells it for $32.67. In a fiercely competitive industry driven by scale and market share, these public comparisons incentivize every participant to keep pushing prices lower.

I expect these side-by-side price comparisons will drive the Amazon Pharmacy and Cost Plus to seek lower prices from their manufacturing suppliers.

So did TrumpRx lower generic drug pricing on day 1? No.

Will it push enough people to Amazon Pharmacy and Cost Plus for them to buy product at volume discounts? Maybe.

Will it drive price competition between Amazon Pharmacy and Cost Plus? Absolutely.

As for the bigger picture, generics account for more than 90% of prescriptions filled in the United States. Any effort to improve the transparency and understanding of US drug pricing is incomplete without including generic drugs. The US dominates quick generic entry and substantial price declines after patent expiration, so any effort that spotlights these wins deserves recognition.

And while we are at it, we should also recognize the innovators and investors behind the original branded medicines who took the scientific and financial risks to develop these once novel therapies that continue to benefit society long after their patent has ended.