Trump’s proposal to lower drug prices

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As former President Donald Trump embarks on his election campaign, he has stirred controversy by spending his time attacking his opponents instead of engaging in policy debates on issues such as health care.

Agenda 47 is Trump’s official campaign platform for the 2024 election. It is separate from the oft-mentioned Project 2025, but outlines his plans on crime, immigration, and other issues.

While Trump’s health care proposals are thin, he has offered some measures focused on drug shortages, pricing and addiction. The United States faces an uphill battle against private, for-profit pharmaceutical companies that are expanding our drug supply, according to Colleen Grogan, a professor at the University of Chicago’s Crown Family School of Social Work, Policy, and Practice.

“Drug companies have tremendous political power,” Grogan said in an interview with USA TODAY. “What we’ve told the American people is, ‘We pay very high prices for our innovations.’ … That’s not true.”

Here’s what we know about some of Trump’s health plans, according to Agenda47.

Agenda 47 on crime: Trump proposes death penalty for drug traffickers, requires stop and search

Bringing pharmaceutical production back to the United States

“President Trump will reinstate his Executive Order 13944 of August 6, 2020 to ensure that essential medicines, medical countermeasures, and critical supplies are manufactured in the United States.”

  • How we got here: The order here cites the Defense Production Act, which gives the president the power to have private industry produce goods needed for national defense. In 2020, the order came at a time when the United States was struggling to obtain testing and protective gear during the COVID-19 pandemic. Biden has since used the same law to help with vaccine production, baby formula shortages and the production of minerals for electric car batteries.
  • In the actual context : Earlier this year, drug shortages surpassed the 2014 record, with chemotherapy drugs, semaglutides such as Wegovy and ADHD drugs in short supply. The Biden administration said in September 2023 that it was exploring ways to bring more production back to the United States, among other potential solutions. Grogan said some shortages, such as insulin, are partly due to the drug’s low profitability. California has tried to address that by contracting a company to make its own insulin.

More: Cancer drug shortage worries doctors and patients: ‘We are at a critical juncture’

Drug companies must get tougher to lower drug prices

On his first day, Trump said he would sign an executive order to once and for all end fraudulent business practices against American consumers.

“My policy is that the U.S. government will tell big pharmaceutical companies that we will only pay the best price they offer to foreign countries that have taken advantage of us for so long. The United States is tired of being ripped off.”

  • How we got here: Americans pay high prices for prescription drugs compared to other countries. An analysis of generic and brand-name drugs in 2022 shows that prices in the United States were 2.78 times higher than in Organization for Economic Co-operation and Development (OECD) countries, according to the U.S. Department of Health and Human Services. In 2020, Trump announced the “most-favored-nation” system, which would have established an international reference price for some Medicare-covered drugs and required manufacturers to disclose drug prices in television ads, according to health policy research and information organization KFF. Both measures were blocked by the courts. Trump also created a new way to get drugs from Canada, according to KFF.
  • In the actual context : The Biden administration passed the Inflation Reduction Act in 2022. It expanded Medicare benefits to cap out-of-pocket drug and insulin prices. It also allows the federal government to negotiate prices for Medicare’s most expensive drugs, overturning a George W. Bush-era law that barred the government from negotiating. Big pharmaceutical companies have challenged those negotiations in court. The first 10 drugs slated for negotiations will go into effect in January 2026.

Grogan called the inflation-reduction law “an important first step” because it initially applies to only 10 drugs. But she also said Medicare’s ability to negotiate lower prices could give private insurers more leverage over drug prices for populations under 65.

“Eradicating America’s Drug Addiction Crisis”

Trump says he will do this by cracking down on cartels, imposing the death penalty on drug traffickers, threatening China to export fentanyl, designating fentanyl a controlled substance and providing more treatment and social support for people struggling with addiction.

  • How we got here: Drug addiction and overdoses have become a growing problem over the past decade, with opioid addiction evolving with different substances such as fentanyl and methamphetamine. The Sinaloa Cartel is one of the deadliest fentanyl trafficking organizations in the world, and in 2017, federal law enforcement began ramping up efforts to hold traffickers accountable. Evidence increasingly suggests that addiction is a chronic disease and that quitting is not a sudden process. USA TODAY has previously reported that tougher penalties for crimes do little to prevent them from happening in the first place. Trump declared the opioid crisis a public health emergency in 2017 and passed the bipartisan Substance Use Disorder Prevention that Promotes Recovery and Treatment for Opioid Patients and Communities (SUPPORT) Act in 2018, according to KFF.
  • In the actual context : In July, two alleged leaders of the Sinaloa Cartel were arrested. Biden has increased access to treatment and Narcan to reverse overdoses, KFF reported. He has also introduced recent proposals to combat fentanyl trafficking by reclassifying the drug for harsher penalties, giving border officials tools to track small shipments and creating a national registry of the pills.

Contributor: Michael Collins, Antoine Robledo, Ken Alltucker, Eduardo Cuevas, Rebecca Morin, Donovan Slack, Lauren Villagran, Josh Meyer, USA TODAY