2026年5月7日 / 美国东部时间早上6:08 / KFF健康新闻 / 哥伦比亚广播公司新闻
自第二届任期开始以来，特朗普总统已宣布、谈判或推出了一系列旨在抑制制药行业过度行为的举措。
这并不令人意外。KFF最近的一项全国民调显示，约60%的美国成年人“担心自己或家人负担得起处方药费用”。超过80%的人认为处方药价格“不合理”，大多数人支持加强监管以降低成本。美国人购买同款处方药的花费大约是其他国家民众的三倍。
去年7月，特朗普致信17家制药商，要求它们主动降低药品价格。随后总统表示，他已在白宫与十多家制药公司高管逐一进行了谈判。去年12月，他宣布已迫使这些药企同意为医疗补助计划（美国为低收入人群提供的政府医保）采用“最惠国”定价。
随后特朗普推出了TrumpRx网站，现金支付的患者可以在此网站上找到折扣药品，同时承诺通过简化FDA审批流程加快生物类似药——某些高价专科药物的仿制药——的上市速度。
这些承诺的范围仍不明确。但最终成果显然不及宣传那般丰厚，部分原因在于谈判的许多细节，甚至包括哪些药物在覆盖范围内，都模糊不清。
白宫发言人库什·德赛未就TrumpRx网站的相关问题回复记者的置评请求。
医疗补助计划本就以大幅折扣采购药品。而其他患者通过商业药品折扣计划——这类计划提供的产品要多得多——或通过保险以及相关药企的共付卡，或许能获得更优惠的选择。
因此，即便部分患者确实从中受益，可能从这些选项中获利的美国民众比例依然很低。
“如果能对任何患者起到作用，那就是一种胜利，”亿万富翁投资者马克·古巴说道，他自身也在致力于降低药价。他指出，TrumpRx网站上针对无保险或保险不覆盖相关费用的患者，提供了品牌 fertility药物和GLP-1减肥药的折扣定价。古巴于2022年创立了马克·古巴成本加成药品公司（简称Cost Plus Drugs），通过去除中间商——直接从工厂采购药品并直接卖给消费者——来低价售药。该公司销售的大部分药品都是仿制药。
哈佛医学院医学教授亚伦·凯塞尔海姆的研究聚焦于药品价格，他表示特朗普的各项声明是“为宣传目的达成的一次性协议，它们不会改变药品定价的整体方式”。
他补充道：“这些协议不透明且无法强制执行。”
例如，目前尚不清楚哪些药品将采用“最惠国”定价，以及该定价的具体定义。但显然并非所有药品都适用该定价。
数据算账
追踪品牌药价格的咨询公司兼数据项目46brooklyn发现，2026年1月有近1000种品牌药价格上涨。更值得注意的是，2025年的挂牌价上涨次数创下历史新高。“这算不上实质性改变，一切照旧，”该公司联合创始人安东尼奥·夏恰说道。
该数据项目显示，2026年第一周，辉瑞将71种药品的挂牌价平均上调了5%，仅下调了1种药品的价格，降幅为9.8%。
对患者而言，最切实的利好或许是特朗普政府悄悄延续了拜登政府的一项计划：针对高价药品的医保药品价格谈判。首批10种药品——包括血液稀释剂、胰岛素以及炎症疾病治疗药物——的谈判折扣已于1月1日生效。部分产品的降价幅度超过50%，每年预计可节省60亿美元，这使得该计划将2025年及以后参保者在D部分处方药上的自付费用封顶在2000美元。
另有15种高价药品——包括热门减肥药和抗癌药——于2025年纳入谈判范畴，折扣后的医保价格将于明年生效。还有15种高价药品将于今年启动谈判。总体而言，这40种谈判敲定的药品价格预计每年可为医保节省超过200亿美元。
即便这些折扣政策生效，制药行业的说客们仍在努力削弱其影响，且已取得一定成效。例如，《一项宏伟法案》将罕见病药物排除在价格谈判之外。
尽管如此，“这仍是历史性突破，因为这是美国首次像其他所有发达国家一样开展药品价格谈判，”凯塞尔海姆说道，“而且你猜怎么着？医药创新并未停滞。”
当然，这些折扣仅惠及医保参保者。特朗普政府的新举措帮助了部分其他患者，但这些举措范围有限，且需要患者了解如何获取折扣。
特朗普的一对一会谈
总统与大型药企负责人的电视亮相促成了一些协议，但这些协议对患者而言几乎没什么实际意义。例如，特朗普与辉瑞CEO阿尔伯特·博拉会晤后，该公司宣布对30多种药品提供折扣。博拉称这项协议“是美国患者的胜利，是美国领导力的胜利，也是辉瑞的胜利”。
这些折扣通过TrumpRx网站提供，该网站还与GoodRx.com联合发放优惠券，而GoodRx早已为数百种药品提供折扣优惠券。
辉瑞大力宣传这项合作，称其是辉瑞与美国政府达成的更广泛的、具有里程碑意义的最惠国（MFN）协议的一部分，该协议能让患者以更低价格购买处方药，“同时强化美国作为生物制药创新全球领导者的地位”。
辉瑞发言人史蒂文·丹恩希援引9月的一份新闻稿称，TrumpRx.gov网站为患者提供的优惠“最高可达85%”。
该网站上架的药品大多为品牌药，与其他制造商生产的便宜得多的仿制药形成竞争，例如降胆固醇药物考来烯胺（Colestid），TrumpRx网站标注该药物“半价”，售价为127.91美元。而在古巴的Cost Plus网站上，同款仿制药售价仅约17美元。
阿拉巴马大学专利法专家肖恩·图表示，这意味着品牌药企通过特朗普的平台降价，实际上并未做出任何牺牲。“如果没有TrumpRx，他们根本不会做这笔销售。”
网站上还有一些非常老旧的药品，例如考的索（Cortef，即氢化可的松），其5毫克规格的辉瑞品牌版本在TrumpRx网站上标价45美元，仅为其91.80美元挂牌价的一半。而在古巴的Cost Plus网站上，该药物售价要低得多。还有一些药物，例如售价607.20美元的艾滋病治疗药物维拉克司（Viracept），仅在与其他未打折药物联合使用时才有疗效。
上周，TrumpRx网站新增了安进公司的修美乐（Humira），这款多年来全球销量最高的药物，标价为每剂950美元，较近7000美元的挂牌价大幅下降。但修美乐于2023年失去了专利保护，此后生物类似药——本质上就是仿制药——已上市。更关键的是，其中两种生物类似药在TrumpRx网站上的售价仅为每剂207.60美元。
由于TrumpRx的大部分产品仅面向无保险、现金支付的客户，关节炎药物Xeljanz的价格从每月2277美元降至1518美元，仍让许多患者难以负担。
几笔值得关注的交易
于2月6日上线的备受吹捧的TrumpRx网站，上架的药品大多为辉瑞的30种药物（约85种药品中的30种），还有少量折扣药物，足以吸引媒体头条。
其中包括德国默克集团子公司EMD Serono生产的三种fertility药物，其中最贵的Gonal-F挂牌价为966美元，但使用TrumpRx优惠券后，每个试管婴儿周期的费用仅为168美元。
美国生殖医学学会发言人肖恩·蒂普顿表示，这些折扣将为女性节省数千美元——但生育治疗的总成本依然让许多人望而却步，因为药物费用仅占总支出的一部分。单个试管婴儿周期的费用在1.5万至2.5万美元之间，女性通常需要进行两到三个周期才能怀孕，这些折扣大约能减少10%的开支。在一些欧洲国家，单个周期的费用约为3000美元。
作为降低这些药品价格的交换，EMD Serono获得了其大多在海外生产的药品的关税减免。该公司还赢得了加速审批其一款在欧洲大力推广的fertility药物的FDA审批流程的权利。
该网站上另一则值得报道的优惠是与诺和诺德达成的协议，涉及司美格鲁肽（Wegovy），这款GLP-1类药物用于减肥和治疗糖尿病，其注射笔价格降至每月最低199美元。（许多保险公司仅为糖尿病患者报销此类药物，而有意减肥的患者需自付费用。礼来公司的同类减肥药泽坎德（Zepbound）也在名单上，售价为299美元。）
市场对诺和诺德和礼来降低美国GLP-1类药物价格的压力日益增大。司美格鲁肽的专利已在印度过期，今年加拿大可能推出低价至每月73美元的司美格鲁肽仿制药，届时海外购药的消费者需求可能进一步增加。
与此同时，加州大学旧金山分校法学院专利专家罗宾·费尔德曼教授表示，美国境内的数十项专利将使司美格鲁肽仿制药在2039年之前无法上市。研究机构I-Mak最近的一份报告深入探讨了药企通过专利操纵手段，在仿制药在欧洲和加拿大上市多年后，仍将其挡在美国市场之外的多种方式。
尽管特朗普政府誓言将加快生物类似药的审批速度，以确保更多竞争和更低价格，但这可能不会产生太大影响。仿制药和生物类似药进入市场的最大障碍通常并非FDA审批，而是需要时间突破美国法律允许药企用来保护知识产权的层层专利壁垒。
例如，2021年FDA批准了用于治疗银屑病关节炎的热门药物Otezla的仿制药，但该仿制药要到2028年才能上市。若药企对“单一来源”药物和生物制品收取的费用高于其他发达国家，其进入市场将需要向医保计划支付回扣。这本质上是让医保计划搭其他国家的便车，借助这些国家的药品价格谈判结果。相关计划仍在制定规则过程中，且同样仅惠及医保参保者，且仅为间接受益。
普通患者如果愿意现金支付，或许能找到一些便宜货。但要找到最优惠的价格可能需要大量对比筛选，迫使患者像选购牛奶或鸡蛋那样精挑细选，仔细对比刚需药品的优惠活动。
数据记者迈亚·罗森菲尔德为本报道贡献了内容。
KFF健康新闻是一家致力于健康议题深度报道的全国性新闻编辑部，是独立健康政策研究、民调与新闻机构KFF的核心运营项目之一。
Trump promised cheaper drugs. Some prices dropped. Many others shot up.
May 7, 2026 / 6:08 AM EDT / KFF Health News / CBS News
Since his second term started, President Trump has announced, negotiated, or floated a flurry of initiatives aimed at taming the excesses of the pharmaceutical industry.
No surprise. About 60% of American adults are “worried about being able to afford prescription drug costs for themselves or their families,” a recent KFF nationwide poll showed. More than 80% consider the price of prescription drugs “unreasonable,” and most support increased regulation to lower costs. Americans pay about three times as much as people in other countries for the same prescription drugs.
Last July, Trump sent letters to 17 drugmakers, demanding they voluntarily lower drug prices. Then the president said he’d negotiated with more than a dozen pharmaceutical executives one by one at the White House. In December, he announced that he had compelled them to agree to “most favored nation” pricing on Medicaid, the government coverage for low-income Americans.
Then came the unveiling of TrumpRx, a site where cash-paying patients could find discounted medicines, and a promise to speed biosimilar products — generic versions of certain high-priced specialty drugs — by cutting through FDA red tape.
The scope of these promises remains uncertain. But it’s certainly less than what the announcement promised, partly because many details of the negotiations, even which drugs are covered, are hazy.
White House spokesperson Kush Desai did not answer queries about TrumpRx.
Medicaid already buys drugs at deep discounts. And other patients may well have better options through commercial drug discount programs, which offer far more products, or through their insurance and associated drug company copayment cards.
So, the share of Americans likely to benefit from these options remains slim, even if some people do come out ahead.
“If it makes a difference to any patient, it’s a win,” said Mark Cuban, a billionaire investor on his own mission to bring down drug prices. He pointed to discounted pricing on TrumpRx for branded fertility drugs and GLP-1 weight loss drugs for people without insurance or whose plans don’t include coverage. Cuban launched the Mark Cuban Cost Plus Drug Co., known as Cost Plus Drugs, in 2022 to sell drugs cheaply by eliminating middlemen — buying from factories and selling directly to consumers. Most of the drugs he sells are generics.
Aaron Kesselheim, a professor of medicine at Harvard Medical School whose research focuses on drug prices, said the Trump announcements are “one-off agreements made for publicity purposes. They don’t change anything about the way drugs are priced.”
He added: “The agreements are opaque and unenforceable.”
It was unclear, for example, which drugs would be sold at “most favored nation” prices or how exactly that was defined. But, clearly, not all were.
Doing the math
46brooklyn, a consulting firm and data project that tracks brand-name drug prices, found that close to 1,000 brand drugs went up in price in January 2026. What’s more, 2025 had the highest number of list price increases ever. “This is not a material change, it’s business as usual,” said Antonio Ciaccia, the company’s co-founder.
In the first week of 2026, Pfizer raised the list prices of 71 drugs by an average of 5% and lowered the price of only one, by 9.8%, the data project found.
The biggest win for patients has likely been the Trump administration’s quiet continuation of a Biden administration program: Medicare drug price negotiation for expensive drugs. The negotiated discounts on the initial 10 drugs — from blood thinners to insulins to medicines for inflammatory disorders — went into effect Jan. 1. With reductions in price of well over 50% on some products, the estimated $6 billion in annual savings allowed the program to cap Medicare patients’ out-of-pocket spending on Part D prescription drugs at $2,000 for 2025 and beyond.
An additional 15 high-priced drugs — including popular weight loss and cancer drugs — were subject to negotiation in 2025, with discounted Medicare prices taking effect next year. And 15 more high-priced drugs are set for negotiation this year. All told, the 40 negotiated drug prices are expected to save Medicare well over $20 billion a year.
Even as these discounts take effect, drug industry lobbyists have been working to limit the impact, with some success. For example, the One Big Beautiful Bill Act exempts drugs for rare diseases from negotiations.
Still, “this is historic because it’s the first time the United States has negotiated prices, like every other developed country,” Kesselheim said. “And guess what? Innovation didn’t stop.”
Of course, these discounts benefit only Medicare enrollees. The newer Trump administration initiatives help some other patients, but they are limited and require knowledge of how to access the discounts.
Trump’s one-on-ones
The president’s televised appearances with the heads of major drug companies resulted in deals, but few, if any, will mean much to patients. For example, after Trump met with Albert Bourla, CEO of Pfizer, the company announced discounts on 30-plus drugs. Bourla called the deal “a win for American patients, a win for American leadership, and a win for Pfizer.”
The discounts are offered via TrumpRx, which, in turn, offered coupons co-branded on GoodRx.com, which already offers discount coupons for many hundreds of medicines.
Pfizer made hay of the deal, announcing it was part of Pfizer’s broader, landmark most favored nation, or MFN, agreement with the U.S. government, enabling patients to pay lower prices for their prescription medicines “while strengthening America’s role as the global leader in biopharmaceutical innovation.”
Pfizer spokesperson Steven Danehy cited a press release from September, noting that the TrumpRx.gov site offers patients savings that “range as high as 85%.”
Most of the list features brand-name drugs, competing with far cheaper generic versions from other manufacturers, such as the cholesterol-lowering drug Colestid, which TrumpRx lists for “50% off” at $127.91. Generic versions cost about $17 on the Cost Plus site.
This means the branded companies aren’t making a sacrifice by offering them at lower costs as reflected on Trump’s portal, said Sean Tu, a patent law expert at the University of Alabama. “That’s a sale they would not have made if not for TrumpRx.”
Others are very old drugs, such as Cortef, or hydrocortisone, whose 5-milligram branded Pfizer version is listed at $45 on TrumpRx, half its list price of $91.80. It sells for far less on Cuban’s Cost Plus site. Still others, such as the $607.20 HIV treatment Viracept, are useful only in combination with other drugs that are not discounted.
Last week, TrumpRx added Amgen’s Humira, for years the world’s best-selling drug, at $950 a dose, down from a list price of nearly $7,000. But Humira lost its patent protection in 2023, and biosimilars — essentially generic equivalents — have since come to market. More to the point, two of those biosimilars are listed on TrumpRx for as little as $207.60 a dose.
Since most of the TrumpRx products are available only to customers without insurance who pay cash, the arthritis drug Xeljanz’s drop from $2,277 to $1,518 a month would still leave it unaffordable.
A few notable deals
The much-touted TrumpRx site, launched Feb. 6, consists largely of Pfizer’s 30 drugs (30 of roughly 85) with a smattering of discounts likely to generate headlines.
These include three fertility drugs from EMD Serono, a subsidiary of the pharmaceutical giant Merck KGaA, the most expensive of which, Gonal-F, has a list price of $966 but is only $168 per IVF cycle using a TrumpRx coupon.
They will save women thousands of dollars — although the overall cost of fertility treatment will continue to put them beyond the reach of many, since drugs represent only a portion of the payment.
The TrumpRx discounts could reduce the $15,000-to-$25,000 cost of a single fertility treatment cycle — women typically need two or three cycles to become pregnant — by about 10%, said Sean Tipton, spokesperson for the American Society for Reproductive Medicine. In some European countries, each cycle costs about $3,000.
In exchange for lowering those prices, EMD Serono got tariffs lifted on its mostly overseas-produced medications. It also won the right to a sped-up FDA approval process for a fertility drug it’s been marketing heavily in Europe.
Another newsworthy offering on the site resulted from a deal with Novo Nordisk for Wegovy, its GLP-1 drug for weight loss and diabetes, with the price reduced to as little as $199 a month for the pen. (Many insurers cover such drugs only for diabetes, leaving those who are interested in losing weight paying out-of-pocket. Zepbound, Wegovy’s Lilly & Co. competitor, is also on the list, at $299.)
Pressure has been building on Novo and Lilly to lower the U.S. price of their GLP-1 drugs. The compounds have lost patent protection in India, and pressure from customers buying overseas will likely increase when generic Wegovy goes on sale in Canada, for as low as $73 a month, possibly this year.
In the United States, meanwhile, dozens of patents should keep Wegovy generics off the market until 2039, said professor Robin Feldman, a patent expert at the University of California Law-San Francisco. A recent report from the research group I-Mak delved into several ways patent manipulation keeps generics off the U.S. market long after they are available in European countries and Canada.
And while the Trump administration has vowed to approve biosimilars more rapidly to ensure more competition and lower prices, that may not have much impact. The big hurdle in getting generics and biosimilars to market is often not FDA approval, but the time it takes to override the thickets of patents that U.S. law allows manufacturers to deploy to protect their intellectual property.
For example, in 2021, the FDA approved a generic of Otezla, a popular drug for psoriatic arthritis, but it will not hit the market until 2028. Its entry would require drugmakers to pay rebates to Medicare if they charged the program more than other developed countries for “single source” drugs and biologics. That would essentially allow the Medicare program to piggyback on other countries that negotiate the prices of some of the most expensive medicines. Those programs are still going through the rulemaking process and, again, would benefit only those covered by the Medicare program and only indirectly.
The average patient-consumer, if willing to pay cash, may find some bargains. But getting the best deal could take a lot of mixing and matching, forcing patients to become choosy shoppers, eyeing deals for essential medicines as they would for a carton of milk or eggs.
Data reporter Maia Rosenfeld contributed to this article.
_KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at_KFF — the independent source for health policy research, polling, and journalism.
