周二晚国情咨文演讲中，特朗普将 “药价下降” 列为其第二任期首年的政绩之一。
他宣称：“我正在终结处方药的天价乱象，往届政府都没能做到。”“我通过刚落地的‘最惠国定价’协议做到了。几十年来，美国民众为处方药支付着全球最高价格，如今我们将成为全球药价最低的国家。”“我把医疗保健的核心 —— 处方药，从全球最高价拉到了全球最低价，这是重大成就。”
美国广播公司采访的专家表示，特朗普在药价领域确有部分成果，但更多降价要么始于拜登政府，要么源于市场竞争，其言论存在明显夸大与片面性。
一、特朗普说对了什么 美国药价确实全球偏高兰德公司研究显示，美国同款药品价格是其他富裕国家的2.7—4.2 倍，特朗普称美国药价全球最高，这一判断符合事实。 部分自费药出现显著降价 特朗普政府与全球最大生殖药企业默克雪兰诺(EMD Serono)达成协议，其热门促排卵药果纳芬(Gonal‑f)等生育用药大幅降价。
特朗普在演讲中举例：一名女性此前自费使用试管婴儿药物，单周期约 4000 美元;如今在 TrumpRx 平台上仅需约 500 美元，降幅最高达90%。 政府通过 “最惠国定价” 与16 家药企达成自愿降价协议，主要惠及无保险、自费购药人群。
二、特朗普说错 / 夸大了什么
1. “把药价从全球最高拉到全球最低”——严重夸大 “最惠国定价” 仅覆盖少数药品，且仅限无保险 / 自费人群，未全面拉低美国市场药价。 该政策遭遇法律与行业抵制，未实现全国性、普惠性降价。 美国医保体系复杂，多数参保人群仍按原有价格购药，未感受到明显降幅。
2. “只有我做到了，往届都是空谈”——不符合事实 近期多数药价下降，主要源于拜登签署的《通胀削减法案》：法案要求药企为 Medicare 提供大幅返利，形成强制降价压力。 减肥药(如 Zepbound、Wegovy)降价，是市场激烈竞争的结果，早在 TrumpRx 上线前就已发生。
3. “TrumpRx 让药价大幅下降”——名不副实 TrumpRx不售药、不直接降价，仅展示自费折扣价、提供药企优惠券，多数优惠在平台外也可获取。 平台目前仅收录43 种药品，而美国 FDA 批准药品数以千计，覆盖面极小。 优惠仅限自费人群，参保者用保险购药通常更便宜，不受平台影响。
4. “药价下降是我行政令的直接效果”——缺乏证据 药剂师、美国经济自由项目高级研究员乔利表示：未在药房看到与特朗普第二任期行政令直接相关的、普遍性日常降价。 多数降价源于既有法律、市场竞争，并非特朗普新政的直接作用。
三、现实局限：降价只是 “杯水车薪” 生育药降价仅覆盖药品成本，试管婴儿的检查、取卵、移植等费用仍高达数万美元，整体治疗依然昂贵。 政策透明度极低：16 家药企的降价协议细节未公开，无法评估实际效果。
药价下降高度分化：自费人群受益，参保人群几乎无变化，未实现全民普惠。
What Trump got right and wrong about drug pricing during State of the Union
During theState of the Unionon Tuesday night,President DonaldTrump pointed to lower drug prices as an achievement ofthefirstyearof his second term.
Trump said heis "ending the wildly inflated cost of prescription drugs," adding that past administrations were unable to do so.
"I gotit done under my just-enacted most favored nation agreements. Americans who, for decades, paid by far the highest prices of any nation anywhere in the world for prescription drugs, will now pay the lowest price anywhere in the world for drugs,"Trump said.
"I took prescription drugs, a very big part of health care, from the highest price in the entire world to the lowest. That's a bigachievement," he added.
Experts tell ABC News thatTrump has made someachievementsindrug pricing, such asreducingthecosts of somein-vitrofertilization(IVF)medications throughtargeted drug discountsfor cash payersandencouragingemployer-provided coverage.
However, they add thatmanyof the other reductionsin drugprices were eitherstarted undertheadministration offormer President Joe Biden orthrough market pressures, especially for weight loss drugs.
"It'simpossible to make a blanketsayingabout prices being lowered. It really depends on where any individual sits in their circumstance,"Kaye Pestaina,vice president at KFF, a nonpartisan health policy research organization, told ABC News."Foroneindividual, they might get some discounts and some significant ones. For another individual, that has employer coverage,it might be cheaper to use their insuranceand thennothing has changed for them."
Some expertstold ABC News thatTrump iscorrect insayingthat the U.S. hasbeenpaying some of the highest drug prices in the world. According toone recent studyfrom the RAND Corporation, a nonprofit global policy think tank, U.S. drug prices run about 2.7 to 4.2 times the costs other wealthy nations pay for the same medicines.
Intherecently announced "GreatHealthcare Plan," Trump proposed to make permanent his administration's "most favored nation" drug pricing agreements-- also known as MFN--to ensure the U.S. does not pay more for prescription drugs than other similar countries, according to KFF.
Under this policy, the administration has been able to secure voluntary price reduction agreements with 16 pharmaceutical companies.Thecompanies pledged to offer discounts on some drugs for people whodon'thave insurance or who pay cash, though the detailsofmanyof these dealsaren'tentirely clear.
Pestainasaid the lack of transparency makes it difficult to evaluate sweeping claims about those agreements.
"To the extent about theMFN-negotiated prices, it's impossible to review since we don't have any access to what those deals were," she told ABC News.
Trump has touted these discount arrangements,featuring them on his new websiteTrumpRx.
However,TrumpRxitself does not lower prices at the pharmacy because itdoesn'tsell drugs,Pestainaexplained.
Thewebsitesimply shows consumers discounted "self-pay" prices and links them to manufacturer sites or coupons, many of which are already available outside the platform, she said
"Youcan go on TrumpRx.gov, download a coupon, and then present it at the pharmacy when you're getting your medicine," Benjamin Jolley, senior fellow for healthcare at the American Economic Liberties Project,told ABC News"So long as you are not using your insurance, you can get a reduction in your cost because the manufacturer is paying the pharmacy a coupon, functionally."
Pestainaadded that theTrumpRxwebsite currently only lists 43 drugs.
"There are thousands of FDA-approved medications.Soit'sa drop in the bucketat the moment," she said.
Jolley also said that many of the price reductions the administration highlights are due to theInflation Reduction Act,which was signed into law by Biden.
That bill created significant incentive for manufacturers to reduce the prices of their drugs, primarily because they would have to pay substantial rebates to pharmacies under the Medicare drug price negotiation program.
Jolley noted that manufacturers were already under competitive and political pressure to reduce prices. For example, the fierce competition among GLP-1 weight-loss drugs likeZepboundandWegovyhad alreadypushed manufacturers to lower pricesand offer direct-to-consumer discounts beforeTrumpRxlaunched.
"But those agreements only apply to people without insurance or paying cash," he said, adding that many people covered by insurance willlikely payfar less than thecost listed on the website.
Jolley, who is a pharmacist, said thathehasnot yet seen sweeping day-to-day reductions in what patients pay at the counter that can be clearly attributed to executive actions taken during Trump's second term.
Pestainaalso cautioned against broad generalizations about savings. She said that proposed policies have faced legal and industry pushback and have notyetbroadly lowered prices across the U.S. market.
However, some experts sayTrumpdidmakesomesignificant price reductions.
During his speech,Trumpreferenceda dealmadelastyear betweenhis administration and pharmaceutical company EMD Serono toreduce the cost of some fertility medications.
EMDSerono, the largest fertility drug manufacturer in the world, agreed to provide discounts for the cost of fertility drugs the company sells in the U.S., including its most popular,Gonal-f, a fertility medication used to stimulate egg development in women and, in certain cases, sperm production in men, according to the administration.
Officials told ABC News last year that afertility drug typically costs between $5,000 and $6,000 per cycle and only about 30% of families have access to some sort of employer-based coverage.EMD Serono will list its fertility drugs online at "very, very heavily reduced prices," Trump said at the time.
During his speech on Tuesday,Trumppointed out a womanin the audience who --he said --benefitedfromthedeal.Before the website discount, he said she used an IVF drug that cost her around $4,000 per cycle of treatment, out of pocket.
The same types of treatments are now listed on TrumpRx for about $500, a reduction of up to 90%.
Jolley saidifTrumpwasreferencingGonal-f,thiswould to be a meaningful price reduction. But IVFstillremainsexpensive, especially if not covered by insurance.
"The discounted medication only covers a portion of the total expense, and procedures, tests, ultrasounds, egg retrieval, lab work and embryo transfer still add thousands of dollars to the overall cost," he said.
