TrumpRx: A Portal to Somewhere We’ve Already Been

On February 5th, the federal government unveiled TrumpRx.gov — a website promising “the world’s lowest prices on prescription drugs.” Forty-three brand-name medications. Five pharmaceutical companies. One very shiny government URL. And Dr. Oz, because of course.

I did what I do — pulled the actual numbers, compared them to what we pay through our wholesalers, and tried not to throw my laptop across the room.

Here’s what I found.

The Portal Problem

TrumpRx doesn’t sell medications. It doesn’t dispense them. It doesn’t negotiate prices in real time. What it does is redirect you — to NovoCare, to LillyDirect, to manufacturer websites, or to GoodRx-powered coupon codes you can print and take to your pharmacy.

Read that again. GoodRx isn’t just involved — they’re the engine. Their own press release calls them a “core integration partner” that is “powering the pricing” on TrumpRx. They host the self-pay prices, process the coupons, and built a Pfizer-branded digital storefront that feeds directly into the site. Before TrumpRx, you could purchase Wegovy directly from Novo Nordisk for $199. Now, thanks to TrumpRx, you can purchase it for…$199. Revolutionary.

This isn’t a new system. It’s GoodRx in a government costume with an eagle logo.

Oh, and about that costume. In 2023, the FTC fined GoodRx $1.5 million — its first-ever enforcement under the Health Breach Notification Rule — for sharing users’ prescription medications and health conditions with Facebook, Google, and other advertisers. For years. Without consent. While displaying a fake “HIPAA Secure” seal. According to the FTC complaint, GoodRx built Facebook “Custom Audiences” categorized by medication — including users who filled prescriptions for Lipitor. Users who searched for Viagra got served erectile dysfunction ads in their Facebook feeds. People who used GoodRx’s telehealth for STDs saw STD testing ads on Instagram. A separate class action cost them another $25 million.

That’s the platform powering TrumpRx. And the company they were sharing your prescriptions with? That’s the same company that curates which news articles, which posts, and which information you’re allowed to see in your feed. They knew what you were taking *and* they controlled what you were reading. Sleep well.

The Numbers Don’t Lie (But They Do Infuriate)

Of the 43 medications listed, roughly 18 have generic equivalents that have been available for years. And this is where it gets fun — if by fun you mean the kind of slow-burning rage that keeps DPC physicians up at night.

Protonix is listed on TrumpRx at $200.10. Two hundred dollars for a heartburn medication. The generic — pantoprazole — sits on my shelf right now. I pay three to four cents a pill. About a dollar for a 30-day supply. Omeprazole, esomeprazole — two to five cents a pill. Even GoodRx has pantoprazole for about seven bucks. The TrumpRx “discount” is roughly 200 times what I pay. That’s not a discount. That’s a markup wearing a costume — and one causing enough heartburn you probably need that pantoprazole.

Pristiq? TrumpRx price: $200.10. I dispense generic desvenlafaxine for about 20 cents a pill — roughly $6 for a 30-day supply. That’s a 97% DPC advantage.

Levoxyl at $36? I dispense levothyroxine for three cents a pill — about 90 cents for a month. Diflucan at $14.06? Fluconazole costs me a quarter.

I could go on. The spreadsheet I built has 18 of these comparisons, and the pattern is the same across all of them: TrumpRx is offering brand-name “discounts” on medications whose generics cost less than your morning coffee.

Where TrumpRx Actually Helps

Credit where it’s due — and I’m not being sarcastic for once. About 60% of the list consists of brand-name drugs with no generic competition — the GLP-1s (Wegovy, Ozempic, Zepbound), fertility medications (Gonal-f, Cetrotide, Ovidrel), and biologics. For uninsured patients paying cash for these specific drugs, the site may point them toward real savings — and afford them the care they need.

But Novo Nordisk was already selling Wegovy at $199 through NovoCare. Lilly was already offering Zepbound at $299 through LillyDirect. Thirty percent of Wegovy prescriptions were already coming through self-pay before TrumpRx existed. The site organized existing prices under one roof and slapped a .gov on it.

The DPC Angle (And the Caveat)

For those of us dispensing from our practices — and I recognize not everyone can, because not all states allow physician dispensing (1-800-CALL-YOUR-LEGISLATOR and ask why) — this is another data point in a long line of evidence that the DPC model already solved a problem the federal government is just now getting around to noticing.

We buy at wholesale. We dispense at or near cost. Our patients walk out with their medications in hand. No coupon codes, no redirects, no fine print. Just a physician, a patient, and a bottle of pills that costs what it actually costs.

Mark Cuban figured this out with CostPlus. DPC physicians figured it out long before him — without a shark or need for a tank. And now the federal government has built a very nice-looking website to figure out what we’ve known for over a decade: the pharmacy middleman markup is the disease, not the cure.

Or to put it more simply:

The government built a website. Cuban built a pharmacy. We just opened the cabinet.

Not because we’re smarter — because we were never dumb enough to let the middlemen in to begin with. And honestly? My prices would be even lower if I bought in larger quantities. I’m a solo doc in rural Maine, not a bulk purchasing operation — and I’m still beating the federal government by a factor of 200.

The Bottom Line

Any move toward price transparency is a step in the right direction, and for patients navigating fertility treatments or GLP-1 access without insurance, the site consolidates genuinely useful information.

But for the 18 medications on that list with cheap, readily available generics — and I suspect that number will grow — TrumpRx isn’t a discount. It’s a reminder of how broken the system still is — and how far ahead DPC has been all along.