President Trump strikes second major drug deal—here's what it means for your medication costs

If you've been watching your prescription drug bills climb year after year, you're not alone. Last Friday brought news that might offer some relief: AstraZeneca became the second major pharmaceutical company to agree to Trump's drug pricing deal, following Pfizer's agreement in September.

This isn't just another Washington announcement that sounds good but changes nothing.

Under the deal, AstraZeneca will charge Medicaid patients "most-favored-nation" prices—the lowest rates offered in other high-income countries.

For context on why this matters: Americans pay nearly three times more for brand-name drugs than other developed countries.

What's actually in this deal for you

AstraZeneca said in a press release that it will allow eligible patients to purchase certain medications at discounts of up to 80% off list prices.

These discounts will apply to drugs for chronic conditions that many Americans know all too well—diabetes, asthma, COPD, and various cancers.

The deal also includes participation in a new website called TrumpRx.gov, where you can buy medications directly from manufacturers.

Here's the catch many news reports got wrong: the TrumpRx website will launch in January, not immediately.

That means if you're counting on relief through this platform, you'll need to wait until next year.

Also read: What Pfizer’s new deal could mean for prescription drug costs in America

The medications that matter to seniors

AstraZeneca isn't just any drug company—they make medications that many older Americans rely on daily.

Their cancer drugs, including Tagrisso for lung cancer, Lynparza for ovarian cancer, and Calquence for leukemia, brought in more than $7.5 billion in US sales last year.

They also produce respiratory medications like Symbicort and Airsupra for asthma and COPD.

Interestingly, AstraZeneca already offers its asthma inhalers for $35 a month under pressure from Senator Bernie Sanders' investigation into drug pricing that began early last year.

The manufacturing angle

This deal goes beyond just pricing.

AstraZeneca is investing $50 billion in US manufacturing by 2030, including a $4.5 billion facility in Virginia creating 3,600 jobs.

The Virginia facility will focus on cancer treatments and chronic disease medications—exactly the types of drugs many seniors depend on.

AstraZeneca also gets a three-year exemption from certain pharmaceutical tariffs as part of the deal.

Trump has been using tariff threats as a negotiation tool, and it seems to be working—at least in getting companies to agree to these arrangements.

Also read: Major cholesterol drug gets huge price cut, saving Americans hundreds each month

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The reality check experts are giving

Before you get too excited, policy experts are raising some important questions.

Experts question the real impact since Medicaid already receives the lowest US commercial prices through "best price" protections.

Rachel Sachs, a law professor at Washington University, pointed out a key concern: "Confidential agreements are not a good way to make public policy."

The details of what companies are actually committing to remain largely secret.

There's also the question of who can actually take advantage of direct-purchase discounts.

If you're on Medicare and have decent prescription coverage, paying cash might actually cost you more than using your insurance.

The direct-pay option seems designed for people who either lack insurance or have such high deductibles that cash prices become attractive.

Also read: Deprescribing medications: A safer approach to senior care

Looking at the bigger picture

This AstraZeneca deal is part of Trump's broader push to address what he calls "global freeloading" on American pharmaceutical innovation.

The administration argues that other countries use price controls to get cheap drugs while Americans subsidize the research and development costs.

The pharmaceutical industry has a different take.

Stephen Ubl, CEO of PhRMA, warned that importing foreign price controls could "result in less access to treatments and cures and reduced investment in manufacturing and R&D."

Also read: Common medications may be fueling a rise in deadly senior falls

What to watch for next

Trump indicated more deals are coming with other major drug companies.

Other large pharmaceutical companies are expected to reach similar agreements in the coming weeks.

Each new deal could potentially expand the range of medications available at reduced prices.

The key question is enforcement.

Unlike Medicare's drug price negotiation program, which has legal backing, these appear to be voluntary agreements.

What happens if companies don't follow through remains unclear.

Also read: Urgent recall affects 2 popular heart medications sold nationwide

The Medicare confusion factor

One important note: this deal primarily affects Medicaid—the program for lower-income Americans—not Medicare, which serves seniors.

Many people confuse the two programs, but they operate separately.

If you're on Medicare, you're already benefiting from the Inflation Reduction Act's drug pricing provisions, including the $35 monthly cap on insulin and upcoming negotiations on other high-cost medications.

However, the direct-purchase option through TrumpRx could still benefit Medicare recipients who hit coverage gaps or face high out-of-pocket costs for medications not covered by their plans.

Read next:

• Medicare may soon cover medications for weight loss—here’s what to know about the proposed program
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• This common kitchen spice could be sabotaging your medications

Key Takeaways

• AstraZeneca became the second major pharmaceutical company, after Pfizer, to agree to Trump’s “Most Favored Nation” drug pricing deal aimed at lowering costs for Medicaid patients.
• The agreement includes discounts of up to 80% for eligible patients and participation in the TrumpRx.gov platform, which is set to launch in January 2025.
• AstraZeneca will invest $50 billion in US manufacturing by 2030, including a $4.5 billion facility in Virginia that will create 3,600 jobs.
• Experts caution that Medicaid already gets significant discounts, meaning real savings for consumers may be limited, and enforcement of the voluntary deal remains unclear.

What's your experience been with prescription drug costs? Have you found any strategies that help manage the expense? Share your thoughts and tips with fellow readers in the comments below—your experience might help someone else navigate these challenging waters.