“The White House would be wise to push DTC programs as a way to lower costs while allowing America to remain the medicine chest of the world,” said health expert Sally Pipes.
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The Trump administration wants to enable more Americans to purchase prescription drugs directly from manufacturers at transparent, discounted prices – collectively saving patients tens of billions of dollars by cutting out middlemen in the drug supply chain.
Voters overwhelmingly favor the president’s idea. In one recent poll90% of Republican voters in congressional battleground states, along with 85% of Democrats and 82% of independents, said they support these direct-to-consumer sales.
It is not without reason that DTC sales resonate with people across the political spectrum. In our complicated and opaque healthcare system, patients intuitively sense that they are being taken advantage of. And they’re often right, especially when it comes to the bloated pharmaceutical supply chain.
In any normal market (be it a retail outlet or a supermarket), prices are clearly displayed so that consumers can see them and make their purchasing decisions accordingly. But when it comes to medicines, patients often have no idea what their prescription will cost in total, what their share of the bill will be at the pharmacy counter and what alternatives are available.
With little visibility into the price of their prescriptions, they have historically been at the mercy of insurers and pharmacy benefit managers. These middlemen have exploited this lack of transparency to pocket secret discounts and fees and send patients there higher costs drugs that increase their profits – and not the drugs that are best suited to patients’ needs. Today is over half of every dollar Spending on branded drugs does not go to the companies that developed them, but to non-manufacturing entities such as pharmacy benefit managers and insurers.
That’s why families feel increasingly pressured by high out-of-pocket drug costs, even as manufacturers’ net prices for brand-name drugs have actually fallen. fallen for years now.
The nation’s largest pharmacy benefit managers – Caremark, Express Scripts and OptumRx – are owned by insurance giants CVS Health, Cigna and UnitedHealth Group, respectively. Together, these three companies operate an effective oligopoly in prescription drug benefits and processing about 80 percent of all US prescription claims in 2024.
But as President Trump recently said, DTC sales enable Americans “cut out the middlemen’ and buy medicines at completely predictable prices.
Eli Lilly, Pfizer, Bristol Myers Squibb and Novo Nordisk have done so DTC sales programs launched for certain medications in recent years. These drugmakers generally offer patients cash prices that are significantly lower than the nominal “list price” of drugs, along with free shipping – all without the hassle of PBM and insurer restrictions, claim denials, prior authorization, or narrow pharmacy networks.
The government can support these private sector efforts by issuing regulations clarifying that these purchases will count toward insured families’ out-of-pocket maximums. That would give patients an added incentive to purchase medications directly, safe in the knowledge that if they eventually face other major health care costs, their out-of-pocket prescription purchases won’t be “wasted.”
The sale of DTC medicines not only makes our healthcare market more transparent, but also more efficient and competitive. As these sales become more common, they may even lower insurance premiums as fewer and fewer drug claims are processed through insurance.
By facilitating the rise of DTC sales programs, the Trump administration would not only be fulfilling the president’s campaign pledge to lower drug prices. It would do this in a way that does not endanger the American biotech industry.
The White House’s other signature drug awards initiativeImporting European price caps would reduce the revenues of US biotechnology companies, resulting in dramatic cuts to research and development budgets. One study It is estimated that this pricing could mean hundreds of new drugs will be developed in the coming decades.
Conservatives know that central government planning does not reduce costs; it creates scarcity and undermines competition in the private sector, which ultimately benefits consumers.
What really works is what has always worked: markets, competition and transparency. The polling on DTC programs proves that voters understand this instinctively. And the White House would be wise to pursue DTC programs as a way to reduce costs while allowing America to remain the world’s medicine chest.
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