Trump’s Drug Price Cut Targets America’s Costliest Prescriptions

President Donald Trump’s recent executive order aims to slash prescription drug prices in the U.S. by adopting a 'most favored nations' pricing model, pegging costs to the lowest prices paid in other developed countries. Trump claims this could cut prices by 50% to 90% for some medications, a bold move to ease the financial burden on Americans. However, experts like New York pharmacist Katy Dubinsky caution that the order’s impact won’t be immediate, as government agencies need months to draft rules.

Below, we dive into the five most expensive prescription drugs in the U.S. by price, followed by the top five by sales volume, highlighting the staggering costs and their medical significance.

Top 5 Most Expensive Drugs by Price:

1. Lenmeldy ($4.25 million) – This one-time gene therapy treats metachromatic leukodystrophy (MLD), a rare genetic disorder ravaging the nervous system in young children. It’s a lifeline to slow disease progression.

2. Hemgenix ($3.5 million) – Designed for hemophilia B, this treatment enables the body to produce its own clotting factor, reducing the need for frequent infusions.

3. Elevidys ($3.2 million) – Aimed at young boys with Duchenne muscular dystrophy (DMD), this therapy slows muscle deterioration, offering hope for a better quality of life.

4. Skysona ($3 million) – Used for cerebral adrenoleukodystrophy (CALD), a severe brain disease in boys, this therapy aims to halt damage before symptoms worsen.

5. Zynteglo ($2.8 million) – This gene therapy for beta-thalassemia helps patients produce healthy red blood cells, potentially reducing lifelong transfusion dependency.

Top 5 by Sales Volume:

1. Keytruda ($25 billion, 2023) – Merck’s immunotherapy powerhouse treats various cancers, from melanoma to lung cancer, fueling over 1,000 clinical trials.

2. Eliquis ($18.95 billion) – A blood thinner from Bristol Myers Squibb and Pfizer, it prevents clots and treats conditions like deep vein thrombosis.

3. Ozempic ($13.93 billion) – Novo Nordisk’s diabetes drug, also a weight-loss sensation, is driving investment in treatments for obesity and heart disease.

4. Humira ($14.4 billion, U.S. 2023) – AbbVie’s blockbuster for rheumatoid arthritis and other inflammatory conditions, with over $200 billion in lifetime revenue.

5. Biktarvy ($11.85 billion) – Gilead’s HIV treatment supports the company’s pivot into cancer research, a financial and medical cornerstone.

While the executive order targets high-cost brand-name drugs, experts like Dr. Jacob Glanville note that generics and vaccines, often under $100, are unlikely to be affected. However, innovative therapies for cancer, autoimmune disorders, and rare diseases—priced up to $500,000 per treatment—face scrutiny. The pharmaceutical industry warns that price caps could stifle innovation, but patients argue the current costs are unsustainable. Balancing affordability with research incentives remains a tightrope walk.