TrumpRx

Summary

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Today, Explained – "TrumpRx" (October 6, 2025)

Podcast: Today, Explained (Vox)
Hosts: Sean Rameswaram, Noel King
Guests: Julie Rovner (KFF Health News), Stacy Dusetzina (Vanderbilt University Medical Center)
Main Theme:
This episode unpacks the latest developments in U.S. health care policy amid a government shutdown, focusing on President Trump’s new “TrumpRx” prescription drug initiative, his deal with Pfizer, and the enduring challenge of high drug costs in America.

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Episode Overview

The episode explores the Trump administration’s recent announcements regarding prescription drug costs: A deal with Pfizer to lower drug prices for Medicaid and the launch of a new online platform, TrumpRx. The hosts and guests dig into the details, examining how substantive (or not) these announcements are, the political motivations behind them, and the broader structural reasons why U.S. drug prices remain high.

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Key Discussion Points and Insights

1. Political Battle Over Health Care Amid Shutdown

• Context Setting: The government shutdown is in its sixth day, with Democrats and Republicans focused on differing issues: reopening the government vs. fixing the health care system.
  • “Republicans want to talk about reopening the government, and the Democrats want to talk about health care.” (Sean Rameswaram, 00:00)
• Bipartisan agreement exists that drug prices are a huge problem, but strategies differ.

2. Trump’s Approach to Prescription Drug Costs

• Trump’s History:
  • In his first term, Trump attempted to lower drug prices through executive orders and regulations, which were largely blocked by lawsuits and court decisions. (Julie Rovner, 02:36)
  • Trump is now more confrontational: “You will make a deal with me or I will do something bad to you.” (Julie Rovner, 03:01)
• Tariff Threats:
  • Trump threatens drug makers with tariffs if they do not lower prices; “If we don't make a deal, then we're going to tariff them an extra 5, 6, 7, 8%.” (Donald Trump, 04:06)

3. The Pfizer Deal – What Was Announced?

• Oval Office Announcement:
  • Trump and Pfizer’s president announce a deal to lower prices for the Medicaid program and to allow direct-to-consumer drug sales via a new portal.
    • “Pfizer is committing to offer all of their prescription medications to Medicaid, and it will be at the most favored nation's prices.” (Trump, 05:29)
• Skepticism About Impact:
  • Medicaid already receives deep discounts by law since the 1990s (Julie Rovner, 05:43).
  • Manufacturing “reshoring” to the U.S. was already happening for pandemic and tariff reasons.
  • Promise not to introduce drugs in the U.S. at higher prices than abroad is largely moot, as drugs typically launch first in the U.S. (Julie Rovner, 06:45)
  • “Their stock actually went up after this announcement.” (Julie Rovner, 07:08)

4. TrumpRx – What Is It?

• Description:
  • TrumpRx is an online search engine—a clearinghouse—for direct-to-consumer drug sales platforms from various pharma companies.
• Who Benefits:
  • Useful mainly for uninsured people or those whose drugs aren’t covered by insurance; most insured Americans won’t benefit.
  • “The idea of Trump Rx is that it's going to be a clearinghouse for all of these various platforms... It's a prescription drug search engine.” (Julie Rovner, 09:03)
  • “If you have insurance and your insurance covers your drug, the chances are you're going to pay less with your insurance than you're going to pay by going directly through the manufacturer.” (Julie Rovner, 10:18)
• Motivation:
  • More about branding than policy impact:
    • “It's a website with his name on it… why does he hate Obamacare? Because it has Obama's name on it.” (Julie Rovner, 10:50)

5. The Medicaid Paradox

• Republican Proposals:
  • Simultaneous with lip service to Medicaid savings on drug prices, Republican budget cuts threaten Medicaid coverage for millions.
    • “They're taking enormous amounts of money out of Medicaid at the same time.” (Julie Rovner, 13:14)
• Guest’s Summary:
  • “A single burger and a nothing burger.” (Sean Rameshboro, 13:26)
  • Trump’s efforts are more symbolic than substantive, yet Americans do pay far more for drugs than peers—a basic bipartisan recognition.
    • “Americans pay too much for drugs. We pay way more per capita than all of our peers.” (Sean Rameshboro, 13:26)

6. Most Favored Nation Status – What Does It Mean?

• Explainer with Stacy Dusetzina (Vanderbilt):
  • Idea: U.S. should pay no more than other wealthy countries for drugs.
  • Challenge: Actual net prices in other countries are secret due to undisclosed discounts and rebates; list prices are not informative.
    • “We don't know for sure what other countries are paying… This is a huge problem.” (Stacy Dusetzina, 18:12)
• Why Do Other Countries Succeed at Negotiation?
  • They have national health coverage and can negotiate as a single buyer.
    • “Other countries negotiate much more effectively than we do. They’re negotiating for the whole country at one time.” (Dusetzina, 20:27)
• U.S. Obstacles:
  • Fragmented system (Medicare, Medicaid, private insurance).
  • Americans expect access to all drugs, reducing negotiation leverage.

7. Policy vs. Politics

• Why Is Progress So Hard?
  • Politics:
    • Both parties want to be seen as fighting high drug prices, but real solutions are complex and politically risky.
      • “The policies are just not as sexy as, you know, politics... You can have a big splashy announcement that sounds like you're making a real change… that doesn’t really do much.” (Dusetzina, 24:51)
  • Policy Complexity:
    • Actual reforms (e.g., inflation caps) are technical, hard to message, and sometimes hit innovation or access concerns.

8. Will Anything Change for Consumers?

• Dusetzina is clear: the average American will see no change from the Pfizer deal or TrumpRx.
  • “Even people taking Pfizer’s drugs… are probably not gonna see any differences in what they pay.” (Dusetzina, 25:53)
• Direct-from-manufacturer pathways work for certain generics, less so for expensive brands.

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Notable Quotes & Memorable Moments

| Timestamp | Speaker | Quote | |-----------|--------------------|-------| | 03:01 | Julie Rovner | “Trump… is basically saying, you will make a deal with me or I will do something bad to you. And that's basically what he's doing with the drug industry.” | | 04:06 | Donald Trump | “If we don't make a deal, then we're going to tariff them an extra 5, 6, 7, 8%. Whatever the difference is, we'll take it that way.” | | 05:29 | Donald Trump | “Pfizer is committing to offer all of their prescription medications to Medicaid, and it will be at the most favored nation's prices. It's going to have a huge impact…” | | 07:08 | Julie Rovner | “Their stock actually went up after this announcement.” | | 09:01 | Julie Rovner | “The Pfizer thing was not a nothing burger. It was just like a single burger.” | | 10:50 | Julie Rovner | “It's a website with his name on it, which is, you know, why does he hate Obamacare? Because it has Obama's name on it.” | | 13:14 | Julie Rovner | “On the one hand, they're saving Medicaid with this drug announcement… On the other hand, they're taking enormous amounts of money out of Medicaid at the same time.” | | 18:12 | Stacy Dusetzina | “We don't know for sure what other countries are paying other countries negotiate prices with drug manufacturers and they get what they call undisclosed discounts.” | | 24:51 | Stacy Dusetzina | “You can have a big splashy announcement that sounds like you're making a real change… that doesn’t really do much.” |

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Timestamps for Critical Segments

• 02:09 – Julie Rovner joins, introduces context on Trump’s drug price efforts.
• 04:06 – Trump’s tariff threats to pharmaceutical companies.
• 05:29 – Trump and Pfizer’s president announce their deal.
• 09:01 – Julie Rovner breaks down “single burger” vs. “nothing burger.”
• 10:50 – Analysis of TrumpRx’s branding and policy impact.
• 13:14 – Contradiction: Medicaid drug discounts vs. Medicaid budget cuts.
• 17:55 – Stacy Dusetzina explains the challenge of “most favored nation” pricing.
• 20:27 – How other countries negotiate lower drug prices.
• 25:53 – Why the announcements won’t impact average Americans.

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Overall Tone & Takeaways

• Tone: Analytical, skeptical, and witty—a balance of policy wonkery and dry political humor.
• Bottom Line: The recently announced measures—Pfizer’s “deal” and the TrumpRx platform—are more sizzle than steak. Despite public outcry and cross-party acknowledgment that drug prices are too high, both structural hurdles and political showmanship keep genuine reform distant. The average American’s drug bill isn’t going down any time soon.

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Episode in a Nutshell

• Trump’s drug pricing moves—threatening tariffs, extracting a deal from Pfizer, and launching TrumpRx—appear headline-grabbing but unlikely to deliver true cost relief to consumers.
• Direct-to-consumer sales work for some, but insurance is still crucial for affordable access to brand drugs.
• “Most favored nation” ideas are undermined by global pricing secrecy and U.S. political fragmentation.
• Beneath every big announcement, the hard work of real reform remains unfinished and politically perilous.

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Listen if you want:
A sharp primer on why U.S. drug prices are so stubbornly high, how presidential “big deals” tend to overpromise, and why every American president wants their own “Obamacare” moment—branding included.

Transcript

[Sean Rameshboro]

It's day six of the government shutdown, but Democrats and Republicans aren't on speaking terms. The Republicans want to talk about reopening the government, and the Democrats want to talk about health care. You've heard it from Senator Elizabeth Warren on this very program, but we don't.

[Julie Rovner]

Take an already broken, creaky health care system and smash it to the ground.

[Sean Rameshboro]

And maybe you've heard it from her colleague Chuck Schumer.

[Elizabeth Warren]

Elsewhere, new data came out today from kff, and that is not Kentucky Fried French fries. KFF could be Kentucky French fries.

[Sean Rameshboro]

Mm, sorry, wrong clip.

[Elizabeth Warren]

And so we ought to be talking about the real issue here, which is that we have a healthcare crisis in America caused by the Republicans.

[Sean Rameshboro]

But up at the tippity top, the president of the United States, who is mostly golfing over the weekend, also wants to talk about the cost of healthcare. He just doesn't want to talk to Democrats about it. Forget about Obamacare. The president wants to talk about Trump. Rx on Today Explained Support for the show comes from BetterHelp. This October 10th on World Mental Health Day, BetterHelp wants us all to take a moment to thank the mental health professionals who've been there for us. BetterHelp makes it simple to connect with a licensed therapist online by doing the initial matching work for you so you can focus on your therapy goals. This World mental health day, BetterHelp is celebrating the therapists who've helped millions of people take a step forward. If you're ready to find the right therapist for you, BetterHelp can help you start that journey. Listeners can get 10% off their first month at betterhelp.com explained. That's better if you h e l p.com explained support for the show today comes from Anthropic, the team behind Claude. Today's news moves fast, but the most important stories deserve deeper thinking. Whether you're trying to understand the implications of a policy change or connecting dots across breaking stories, Claude, your new AI collaborator, can help you go beyond the headlines. Claude doesn't just summarize the news. It helps you explore the context, analyze the patterns, and think through what it all means together. Try Claude for free@Claude AI todayexplained.

[Julie Rovner]

This is today Explained. I am Julie Rovner. I am chief Washington correspondent for KFF Health News, and I'm host of our weekly health policy podcast, what the Health.

[Sean Rameshboro]

What the Health Did? Did you name it?

[Julie Rovner]

I did.

[Sean Rameshboro]

All right, great name. So let's start with the biggest news out of Washington right now and the question on everyone's mind. Pharmaceutical drugs.

[Julie Rovner]

Hey, it's an oldie but goodie.

[Sean Rameshboro]

What's going on?

[Julie Rovner]

Well, this is something that President Trump was very insistent on in his first term.

[Donald Trump]

For decades, our citizens are paid the highest prices for drugs, prescription drugs, anywhere in the world. And it's not even close that the.

[Julie Rovner]

US Pays more for prescription drugs than any other country, which is true and which pretty much everybody agrees with. So in his first term, President Trump tried a whole bunch of what we would call normal activities to try and lower prescription drugs, putting out executive orders.

[Donald Trump]

Today I'm signing four sweeping executive orders that will lead to massive reduction in drug costs. Massive.

[Julie Rovner]

And regulations. And the drug industry, which did not want to lose their ability to charge more in the US Than in other countries with price controls, went to court and they won. So that didn't work. So now we are in Trump 2.0. And Trump, as we've seen with a number of different entities, other countries, regarding tariffs, universities, regarding things that he doesn't like to see, is basically saying, you will make a deal with me or I will do something bad to you. And that's basically what he's doing with the drug industry. Now, he said back earlier this summer that the drug industry must lower its prices in a number of ways. And if they don't do that, he's going to slap very large tariffs on them.

[Donald Trump]

We're making deals with all of them. And I said, if we don't make a deal, then we're going to tariff them an extra 5, 6, 7, 8%. Whatever the difference is, we'll take it that way.

[Julie Rovner]

So that's how we got to last week.

[Sean Rameshboro]

And we get a big announcement last week. And what exactly is it?

[Julie Rovner]

Big announcement in the Oval Office.

[Donald Trump]

I think this is one of the biggest medical announcements that this office has ever made.

[Julie Rovner]

President Trump brought in the president of Pfizer, one of the largest US Drug makers, to announce that they had struck a deal to lower drug prices.

[Elizabeth Warren]

Mr. President, what. What an honor to be here today in this office to announce a landmark agreement. I think it's an historic day.

[Donald Trump]

Is this the coolest office? He has a beautiful office, but the Oval is the coolest.

[Sean Rameshboro]

Right.

[Donald Trump]

What do you think?

[Julie Rovner]

I think by far, although we don't know exactly the details of the deal, because that is proprietary, so we only know what they told us.

[Elizabeth Warren]

It's an histor day, because I think today we are turning the tide and we are reversing an unfair situation, which.

[Julie Rovner]

Was a couple of things that Pfizer had promised to Lower prices for the Medicaid program that, you know, pays for drugs for people with low incomes, and that's jointly financed by the federal government and the state.

[Donald Trump]

Today, Pfizer is committing to offer all of their prescription medications to Medicaid, and it will be at the most favored nation's prices. It's going to have a huge impact on bringing Medicaid costs down like nothing else. I told you that.

[Julie Rovner]

Which sounds great, except that Medicaid already requires drug makers to offer extremely deep discounts. It has since the 1990s. Pfizer also agreed to put up a portal where people could buy drugs directly from them without going through drug middlemen like their insurance company or these pharmaceutical benefit managers, which might or might not actually reduce drugs, the eventual cost to the consumers. And Pfizer promised to do some more manufacturing here in the US which has been one of Trump's big asks, basically reshoring manufacturing of drugs, which is probably not a bad thing. During the pandemic, there was a big concern about how much of our, if not just our drugs, but our active ingredients for drugs come from other countries. When the whole distribution system was messed up, Pfizer promised that they would not introduce drugs in the United States a higher price than they introduce them in other countries. Except the catch to that is that most US Drug companies introduce their drugs in the United States first. So there is no lower drug price in other countries yet. Mm.

[Sean Rameshboro]

So do we think the company will actually go through with all of the promises they made in the Oval Office, or is this kind of just like a let's go do the song and dance and then see what we actually have to commit to?

[Julie Rovner]

Oh, no, we think they'll go through with it because none of the things that they're gonna go with are going to meaningfully lower drug prices. And how do I know that? Because their stock actually went up after this announcement. So they made promises that conveniently are either things they were like slight add ons to things they were already doing. A lot of companies, as I say, were already bringing back manufacturing to the US for supply chain reasons as much as anything else, and safety reasons, and worried about the next pandemic reasons. And also because of tariffs. They were. That's one of the things that tariffs are supposed to do, is force manufacturing back to the United States. So a lot of drug companies are already doing that. But this is kind of a delicate dance. They know that they are in his crosshairs. As I said that, you know, Trump has been making noise about high drug prices since his first term. And he's not alone. Democrats agree. You know, Bernie Sanders is just as loud about saying that the United States is basically subsidizing the rest of the world in terms of drug prices.

[Elizabeth Warren]

We in the United States paying by far the highest prices in the world for prescription drugs. Same exact medicine, same brand names are sold in Canada, the U.K. france, Germany, at significantly lower prices than what we pay here in America.

[Julie Rovner]

That's very much agreed upon. The question is, you know, how much can you cut into drug price profits before you actually hurt their ability to continue to make and invent new drugs?

[Sean Rameshboro]

Mm. Okay, so the Pfizer thing, it sounds like a bit of a nothing burger, but there was another announcement made in that Oval Office that day. It was Trump rx.

[Julie Rovner]

Yeah, I think I would say that the Pfizer thing was not a nothing burger. It was just like a single burger.

[Sean Rameshboro]

Like you're still hungry after you eat.

[Julie Rovner]

Yeah, like you're still hungry. Like what you would get for your five year old Trump Rx might be described as a nothing burger. It doesn't exist yet. I'm sorry. Trump rx. It's a fine, not harmful idea. A lot of these drug companies are now selling direct to consumers, as I mentioned earlier. So you don't go through the drugstore, your pharmacy benefit manager or your insurance, which I'll get to in a second, but they sell at a discount directly to consumers. It started, I think it picked up a lot of steam with a lot of the weight loss drugs, which a lot of it insurance doesn't cover. So you can buy your weight loss drugs directly from the manufacturer. You'll pay less than you would if you went to the pharmacy without insurance. But if it's, if you have insurance that happens to cover it, it's still a lot more expensive. And I think that's what happens with a lot of these direct to consumer, from the manufacturer products. The idea of Trump Rx is that it's going to be a clearinghouse for all of these various platforms. So there'll be all of the drug companies that have these direct to consumer sales platforms will be available on Trump R. It's just an, It's a search engine. Basically. It's a prescription drug search engine.

[Sean Rameshboro]

But you say nothing. Berger. How come?

[Julie Rovner]

Because it's not going to. It could make it easier for some people. But as I say, if you have insurance and your insurance covers your drug, the chances are you're going to pay less with your insurance than you're going to pay by Going directly through the manufacturer. These manufacturer, direct from manufacturer to consumer products are for people who don't have insurance, don't have insurance for that drug, or are low enough income that they qualify for some of these, what are called patients assistance programs, where they can get a deep discount.

[Sean Rameshboro]

Huh. Then why make a big deal out of this?

[Julie Rovner]

Because Trump likes to make big deals out of things. I'm desperately serious. It's a website with his name on it, which is, you know, why does he hate Obamacare? Because it has Obama's name on it. He has cared a lot about lowering prescription drug prices. And here will be a website with his name on it that will enable some people, maybe a few people, to get lower priced prescription drugs.

[Sean Rameshboro]

Are you saying that he did this to put his name on something related to health care?

[Julie Rovner]

I'm not saying that directly, but I'm saying that that is probably a beneficial side effect as far as he's concerned.

[Sean Rameshboro]

Well, I mean, we all know why he hates Obamacare. As you said, it's got Obama right in the name. But Medicaid costs feels like an easy win for him. A lot of his voters will be affected by the cuts that, that the GOP is making to Medicaid. And that's what the Democrats are so upset about right now.

[Julie Rovner]

What the Republicans are saying is they would rather shut down the federal government than actually extend the health care coverage to 15 million Americans who were getting it, but the Republicans are taking it away.

[Sean Rameshboro]

If this is something that Trump has cared about since his first term, why not just not cut Medicaid in addition, maybe to a deal with Pfizer and Trump?

[Julie Rovner]

Rx well, that's a good question. And it's a question for the president and for Republicans about why they are cutting Medicaid.

[Sean Rameshboro]

Should we reach out to him? Let's reach out to them.

[Julie Rovner]

Well, I've reached out to him. I haven't heard back yet. First of all, as I said at the top, Medicaid already is required by law to provide very deep discounts for drugs. People who are on Medicaid don't generally pay for their drugs because they don't have very much money. Those drugs are paid for by the state and the federal government. And yes, lowering even further prices that prescription drug makers charge for Medicaid drugs will save a little bit of money for the federal and state governments. It's probably not gonna show up at the counter for patients. But obviously the overarching piece of this is that in the big, beautiful bill that Congress passed back in June President signed July 4th. There are these enormous trillion dollar Medicaid over the next few years and it's gonna result in many people losing their Medicaid. So you know, on the one hand, they're saving Medicaid with this drug announcement, a little bit of money. On the other hand, they're taking enormous amounts of money out of Medicaid at the same time.

[Sean Rameshboro]

Julie Rovner, KFF Health News Check out her show what the health if you know what's good for you. So a single burger and a nothing burger. But Trump does have a point. At least one point. Americans pay too much for drugs. We pay way more per capita than all of our peers. It's a point Biden made before him.

[Elizabeth Warren]

Americans pay more for prescription drugs than.

[Sean Rameshboro]

Anywhere in the world.

[Elizabeth Warren]

It's wrong and I'm ending it.

[Sean Rameshboro]

And one that Obama made before Biden.

[Elizabeth Warren]

It's become clear that some of these companies are dramatically overcharging Americans for what they offer. They sell the exact same drugs here in America for double the price of what they charge in Europe and Canada.

[Sean Rameshboro]

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[Stacy Ducetzina]

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[Sean Rameshboro]

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[Stacy Ducetzina]

This is Today Explained.

[Sean Rameshboro]

Stacy Ducetzina is a professor of health policy at Vanderbilt University Medical center in Nashville, Tennessee. We asked her about one part of the President's big announcement several days ago. He wants the United States to get something called most favored nation status.

[Stacy Ducetzina]

When we've seen this come up in prescription drug policy, usually that means we look at countries with similar economies to ours who have pretty robust access to prescription drugs, and we'll say, okay, now we want to understand what did they pay and we want to pay the lowest of those prices. So despite the efforts politically to move forward with legislation in this space, one key problem that always comes up is we don't know for sure what other countries are paying other countries negotiate prices with drug manufacturers and they get what they call undisclosed discounts. So we can see maybe a sticker price, but that's not necessarily the price that that country is ultimately paying. That price that they pay we would call the net price, net of all rebates and discounts. This is hidden from us currently. This is not a small problem for the administration or for any policy that tries to use international reference pricing. This is a huge problem because if all we can see is your sticker price, there's nothing necessarily to say that, you know, companies couldn't push up the sticker price, keep the net price low in other countries, and then be able to say, well, we got the similar deal to those other countries, just might not necessarily be a good deal.

[Sean Rameshboro]

So if I'm picking up what you're putting down, drug companies get to set prices, and those prices vary country to country. And some countries get favorable treatment, but we don't really know which countries and how favorable the treatment. But Donald Trump would like the United States to get more favorable treatment. And that is called most favored nations status.

[Donald Trump]

That's what it is.

[Sean Rameshboro]

Is that all right?

[Stacy Ducetzina]

Yes. So what we tend to know is that on average, across all purchasers in the US Versus international prices, we tend to pay quite a bit more than other countries.

[Sean Rameshboro]

And why do we know?

[Stacy Ducetzina]

Yeah, so other countries negotiate much more effectively than we do. And this is partly because they're negotiating for the whole country at one time. So most of these countries have some form of, like, kind of government coverage or like national health insurance that allows them to say, for example, I'm going to negotiate with this drug company. They do value assessments. So what that means is that they basically compare the benefit of this new treatment that's coming into their market relative to whatever is the current standard of care. They decide how much money that's worth from a clinical and economic perspective. And then they say, okay, based on the clinical benefits of this drug, this is how much money we're going to pay you. And if companies are not willing to agree to that price, these countries will often say, well, then you're just not going to get to sell your drug to anybody in our country. We, on the other hand, in the US Have a couple of things that limit our negotiation. One is that we don't have a single payer. We have Medicare, Medicaid, we have private health insurance plans. There's a lot of fragmentation. So it's not just one group negotiating. We also have the desire to have access to everything. So it's pretty American. And I totally get this. We want to have access to all the drugs. If our negotiations basically said, well, this drug isn't worth it for us to cover, some people are not going to be on board with that.

[Sean Rameshboro]

So why can't we figure it out? I mean, the president wants to do it.

[Donald Trump]

Most favored nation. We are going to pay the lowest price there is in the world.

[Sean Rameshboro]

The last president wanted to do it. Come on, Congress wants to do it. Why can't we deliver on this issue?

[Stacy Ducetzina]

Yeah, meaningfully.

[Sean Rameshboro]

Meaningfully. Meaningfully.

[Stacy Ducetzina]

I think it's politics and policy aren't necessarily aligning here very well. So the politics of it, no matter where you sit, which part of the aisle you're on, or if you're independent, you are likely to want to say that you are going to do something about drug prices because you know how.

[Elizabeth Warren]

Popular that this is really a matter of basic fairness. The pharmaceutical companies have gotten huge, they've gotten powerful, they've gotten rich. And they are asking American consumers to pay more, hundreds of times more in some cases than they're asking our European counterparts. That's just wrong. I told the pharmaceutical companies when I was in business, you can't charge Americans more than you charge Europeans. And that's what we did. It's pretty basic. I think both Democrats and Republicans agree we've got to reduce drug prices.

[Stacy Ducetzina]

You know, your constituents are worried about this. The reality though, when you start to figure out, like, what you could do is that there are different views about, like, who should be in charge of this. So Republicans have tended to want this to be more of a, you know, private market manages this. And then there are legitimate concerns about, you know, if you're very heavy handed with setting prices, you may harm innovation in drug development, which is really important to Americans and important to all of us and our health. So there are some legitimate concerns about, like, how do you solve this from a policy perspective? And like, do you let the private market do this? Do you regulate more? So that ends up being really challenging as you start to think about how to craft policies to improve the situation. The other thing is, is that policies are just not as sexy as, you know, politics when it comes to, you know, you can have a big splashy announcement that sounds like you're making a real change to like, prices or access to drugs for the population that doesn't really do much.

[Donald Trump]

These drugs will be available for direct purchase online at a website operated by the federal government.

[Stacy Ducetzina]

Or you can have a policy change that is like addressing a lot of complexity in the system that nobody has a media sound bite to talk about. So I think that's one of the other things is messaging is really hard. It's a lot easier to say you're doing something splashy, but then, you know, if I told you about like modifying the inflation penalty for Medicare drugs, you're like, okay, thanks.

[Sean Rameshboro]

I'll take your word for it.

[Stacy Ducetzina]

Right. It's boring to the average person. You're like, I have no idea what you're talking about.

[Sean Rameshboro]

Okay, so, you know, hearing you talk about making a big, splashy announcement being easier makes me think of where we started with this show, which is that the president several days ago made a big, splashy announcement. And if I'm understanding you, it sounds like that isn't gonna equate to meaningful change in how much Americans are paying for their drugs.

[Stacy Ducetzina]

Yeah, I think when looking at the details that are available here, the average American's not gonna experience any change from this agreement. And even people taking Pfizer's drugs, which are the subject of this first agreement, are probably not gonna see any differences in what they pay. And I think the thing that seems attractive about these options are that a lot of people are familiar with buying generic drugs this way and saving a lot of money relative to if they use their health insurance benefit. But branded drugs are just so much more expensive that it often doesn't make sense for people to buy those outside of their health insurance.

[Sean Rameshboro]

You know what, sometimes my pharmacist will be like, hey, I got you a deal on this. And I'll be like, I didn't even ask. That's so nice. That's so nice.

[Stacy Ducetzina]

Yeah. I think pharmacists are phenomenal people, you know, like, they are right at the front lines. And like, think about it like, if you could help solve a problem for someone like that, that was legitimate problem for them. That's probably the highlight of your day.

[Sean Rameshboro]

This is a nice place to leave it, I think, you know, shout outs to the pharmacists.

[Stacy Ducetzina]

Shout outs to pharmacists.

[Sean Rameshboro]

Also, shout outs to Stacy Dusatsina at Vanderbilt. Shout outs to Kelly Wessinger for making the show today. Shout outs to Jolie Myers for ed editing, Laura Bullard for fact checking, and Adrian Lilly and Patrick Boyd for mixing this episode of Today explained. I forgot to say my name. I'm Sean Ramisboro.

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