5 Ways Trump’s Prescription Drug Order Could Impact the Middle Class
Written by
Kerra Bolton
Edited by
Angela Corry
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President Donald Trump signed an executive order aimed at lowering prescription drug prices by tying U.S. costs to the lowest prices paid in other developed nations.
While the policy promises long-term relief on medication costs, its short-term effects are uncertain and depend on ongoing responses from legal, legislative and industry stakeholders.
Here are fiveways Trump’s prescription drug order could impact the middle class.
What Is It?
Centered on the “Most Favored Nation” pricing model, the executive order expands Medicare’s ability to negotiate costs and pushes for more domestic drug manufacturing, according to the Associated Press.
“The order gives a 30-day window for pharma companies to lower prices voluntarily and outlines potential follow-up actions, like regulatory rulemaking and antitrust enforcement, if those targets aren’t met, said Anshul Mangal, CEO of Project Farma.
Mangal added, “While the intent of the order is clear, the practical impact will depend on industry response and implementation feasibility.”
Ease Cost Burdens
George Carrillo, the former Director of Social Determinants for Health in Oregon and who now leads the Hispanic Construction Council, said the executive order could provide much-needed relief to middle-class families by addressing the high cost of prescription drugs.
“For example, insulin that costs around $98 per vial in the U.S. can be as low as $11 in Germany,” Carrillo said. “Adopting similar pricing could significantly lower out-of-pocket expenses for families relying on essential medications like insulin, along with other high-cost treatments.”
If adopted widely, this pricing model could ripple beyond Medicare, potentially lowering premiums and out-of-pocket costs for middle-class families with private insurance.
“While these changes wouldn’t happen overnight, the promise of lower medication costs could bring meaningful, long-term benefits for those juggling hefty healthcare expenses with everyday financial demands,” Carrillo said.
Relief May Not Reach Everyone
While the executive order could help Medicare recipients save on costly infusions and injections, it does little to alleviate the everyday cost burden on middle-class families struggling with prescription costs.
“For working families, especially those not on Medicare, it wouldn’t make a dent in the high cost of everyday meds like birth control or antibiotics,” said Kavelle Christie, health policy expert and CEO of Orion 360 Health, LLC.
Christie added, “Middle-class folks are still stuck between rising deductibles, patchy insurance and sticker shock at the pharmacy. And none of that changes just because Medicare negotiates a few prices.”
Risks Could Undermine Savings
Rather than accept lower prices, drugmakers could disrupt access for patients, especially those with chronic conditions.
“Drug companies might start playing games: raising prices overseas, holding back drugs in lower-cost countries, or cutting access in rural hospitals where margins are already tight,” Christie said. “If the rollout isn’t thoughtful, we could see even more delays in getting new medications or fewer clinics offering the ones we already rely on.”
Christie explained, “The fact is, because Trump’s order didn’t come with strong implementation rules, unlike the Inflation Reduction Act, which does, the benefits might never actually reach patients.”
In addition, legal challenges could also delay or block the order, resulting in mid-year coverage changes and confusion for families.
“There is a possibility that courts could halt the order because it arguably circumvents the rulemaking requirements of the Administrative Procedure Act,” said Seann Malloy, founder and managing partner at Malloy Law Offices. “In the event that the litigation delays implementation, patients could face confusion or formulary changes that suddenly occur midyear, a worrying prospect for people living with chronic disease.”
Shifts in Coverage and Care
As insurers respond to policy changes, patients may face shifts in drug formularies or delays in treatment decisions tied to reimbursement uncertainty.
“Patients should also watch for their providers to start looking at changing drugs or putting off treatments over uncertainty about repayment,” Malloy said. “Legally, if the order withstands court challenges, it could lay the groundwork for future executive-driven price interventions.”
Malloy said these changes could directly affect the stability of care for the middle class.
Potential Trade-Offs for Medical Innovation
Carrillo said one risk with Trump’s executive order is that it could unintentionally impact funding for research and development, which makes up about 15-20% of drug companies’ budgets.
“If revenues drop due to reduced Medicare payments, companies might scale back on innovative projects, which could slow the pace of breakthroughs in critical areas like cancer treatments, autoimmune drugs, and rare disease therapies,” Carrillo said. “It’s essential to strike a balance that ensures these life-changing advancements continue while keeping medications affordable for patients.”
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