When TrumpRx launched in February, it joined a chorus of websites claiming to have deals on prescription drugs.
Despite the hype, many of the medicines on TrumpRx include brand-name drugs that patients can find cheaper elsewhere — as generics.
For instance, Protonix for heartburn and gastroesophageal reflux disease is available for $200 on TrumpRx. But the generic version, called pantoprazole, cost less than $30 with a coupon from GoodRx, another drug discount website. And depending on the health plan, using insurance could mean a $5 or $0 copay.
So with sites like TrumpRx, GoodRx, Mark Cuban's Cost Plus Drugs and a dizzying list of patient assistance, copay cards and even cash options from the drug companies themselves, what can you do to make sure you're getting the best deal on your prescription?
Well, there are no shortcuts, and it's going to take a little work to figure it out.
"I'm not sure that all of the options make things better," says Ben Rome, an internist and drug policy researcher at Brigham and Women's Hospital in Boston. "In some cases they do, and in some cases they might just make things more confusing if you're a patient or doctor trying to figure out where you should go to buy your medicines."
"There isn't a one-stop shop," he says.
Start by talking to your doctor and asking about the lowest cost options. But because insurance plans vary and the discount landscape is constantly changing, it's possible neither of you will know your share of the drug's cost until you go to pay at the pharmacy counter, Rome says.
Here are a few steps you can take to navigate the growing world of drug discounts.
Ask about a generic
When your doctor is writing a prescription, it's not a bad idea to ask if the drug is available as a generic. But don't sweat it if you forget. You can ask your pharmacist about generics, too.
Generics drugs are copies of the brand-name versions that are often cheaper while still being available at your regular pharmacy. For example, blockbuster cholesterol drug Lipitor's generic name is atorvastatin.
According to the generics trade group Association of Accessible Medicines, 90% of prescriptions filled in 2024 were generics, but they only accounted for 12% of all drug spending. Translation: They're a lot less expensive.
"Most generics — not 100%, but most generics — are relatively affordable, relatively low cost," says Douglas Hoey of the National Community Pharmacists Association. "Low cost and affordability can vary from person to person, but generally, they're going to be under $30, $40 and sometimes even under $10."
Not all brands have generic versions, however. That's because they're only allowed on the market after a brand-name drug's patents and other government-granted protections have expired. Then generic versions of drugs go through a Food and Drug Administration approval process and eventually to pharmacy shelves.
You can find out about a drug's generic status by asking your pharmacist, asking your doctor or checking your insurance company's app if they have one, says Lou Zollo, a former pharmacist who is now vice president and national pharmacy practice leader at the consulting firm Segal. You can also search online — try a pharmacy or chain drugstore website.
What if there isn't a generic?
There might be another drug in the same category. Take, for instance, Eliquis and Xarelto, two brand-name blood thinners that are similar. They're not identical, but sometimes your doctor will be comfortable with you taking either one. And one might be cheaper than the other, depending on your insurance.
"You, the average consumer, I don't think will have the information to know whether this has a less expensive therapeutic equivalent," says Zollo, explaining that you can ask your pharmacist about the substitution.
And sometimes, the alternative drug even has a generic. It can't hurt to ask. Again, it's always good to ask early — as your doctor is writing the prescription. But if you forget, your pharmacist can help.
"Your pharmacist is the medication expert," says Hoey. "We have a minimum of six years of college education on medications. So that's your best bet."
But it's a little trickier to switch to another drug once you're at the pharmacy because you'll need a new prescription, says Zollo: "Now it's back to the prescriber to say, 'Hey, can I try this instead?' "
OK, so you definitely need a brand-name drug … now what?
While there are plenty of ways to go outside your insurance and get a discount, you should check in with your doctor and let them know the price is causing problems if you haven't already.
"As a primary care doctor, I want to know if my patient is struggling to afford the medicine," says Rome, adding that patients often incorrectly assume their doctors already know.
Often, they can help you make a plan. For example, your doctor may be able to appeal an insurance company's decision or get a prior authorization if your insurer requires one for the doctor's recommended medicine.
If it's not covered or your copay is too much
Now that you've exhausted other options, you'll want to check for drugmaker discounts. You've got a few options.
You can start by checking the search-by-drug tool maintained by the Pharmaceutical Research and Manufacturers of America, the brand-name drug industry trade group. It can pull up a list of brand-name savings options available to you from the drug companies themselves.
These include patient assistance programs for people who are uninsured or underinsured, as well as copay cards, which help offset copay patient costs at the pharmacy counter. Drug companies sometimes have discounts for customers not using their insurance and paying cash.
But Rome offered a word of caution: "They're at the whim of the manufacturer and manufacturers can discontinue or change those programs at any time. So just because you have access to the coupon program this year doesn't mean the program will continue next year."
Depending on the company program, you may need to provide paperwork to qualify. And people with Medicare or Medicaid aren't eligible for some of them.
What about all these discount sites?
Before paying cash and going outside your health insurance, you should check coupon or discount sites to see if they have a lower price, says Rome. Never pay more than the cash price at a discount site, unless you know you're going to hit your deductible and it will save you money later in the year.
The big ones are GoodRx, Cost Plus Drugs, Amazon Pharmacy, Costco and Walmart. But according to Rome, who has done studies examining these sites, there's no easy answer for which one will have the best price on any given day. You'll have to search and compare.
"The prices vary a lot and they can vary over time. And so it's not clear where you go first," Rome says. "Where's the cheapest option for you for this medicine now? TrumpRx is in the mix. Will that be the least expensive option? Maybe in some cases, yes. Maybe in other cases, no."
He acknowledges that it takes time, and encourages patients to keep their doctor in the loop.
For what it's worth, Hoey at the National Community Pharmacists Association says your local pharmacist probably prefers Cost Plus Drugs coupons. The price includes an administration fee and Cost Plus Drugs doesn't claw back money from the pharmacy so that it has to dispense the drug at a loss.
"It's gotten more complicated simply because there are more choices and there are more options," says Zollo, the consultant at Segal. "And I'm not sure from a consumer point of view that more is necessarily better."
Want to share your experience navigating drug discounts with NPR? Send an email to slupkin@npr.org.
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