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“And under my most favored nation agreement on drug prices, we went from paying the highest drug prices anywhere in the world just a few months ago … to the lowest drug prices anywhere in the world.”
That’s President Donald Trump at an Oct. 20 rally in Greenville, North Carolina, as reproduced by FactCheck.org (1).
I’ve been a CPA since 1981, and I’ll give the president his due: some drug prices really are coming down, especially for people on Medicare. The White House says patients “have saved over $700 million on medicines through TrumpRx.gov” since it launched (2).
But FactCheck.org called the “lowest drug prices” claim “exaggerated.” It said Trump’s efforts “may have lowered prices for some consumers buying certain drugs,” but that “there isn’t evidence the deals so far have led to broad decreases in drug prices” (1).
And if you’re on Medicare, two numbers are going up next year, not down.
Medicare open enrollment runs from Oct. 15 to Dec. 7 (3). Here’s what’s real, what isn’t, and what to do before it ends.
1. Some of the price cuts are real
Medicare’s first negotiated drug prices took effect Jan. 1, 2026, for people with Part D coverage (4). CMS, the agency that runs Medicare, estimated in 2024 that enrollees would save $1.5 billion in out-of-pocket costs in 2026 (4).
The negotiation program is required by the Inflation Reduction Act (4). The newest round was announced under the Trump administration.
In November 2025, Medicare announced lower prices on 15 more drugs that take effect in 2027, including a 71% discount on Ozempic, Wegovy and Rybelsus, NPR reported (5).
Trump’s health secretary, Robert F. Kennedy Jr., said at the time: “President Trump directed us to stop at nothing to lower health care costs for the American people” (5).
That could mean real savings starting in 2027 for Medicare enrollees who take those drugs.
2. ‘Lowest in the world’ isn’t what the data show
The best broad comparison I know of comes from RAND, a nonpartisan research group. Using 2022 data, it found that “Across all drugs, U.S. prices were 278 percent of other countries’ prices” (6).
For brand-name drugs, the gap was wider: U.S. gross prices, before rebates, were 422% of those in the comparison countries (6). The one bright spot: “The United States had lower prices for unbranded generics than most countries” (6).
To be fair, that data predates Trump’s drug deals. But my read is that discounts on some drugs don’t close a gap that big in a year.
FactCheck.org was similarly skeptical, adding that “experts told us there’s no guarantee of substantial savings for Americans in general in the future” (1).
3. Your Medicare drug cap is going up in 2027
Here’s the part you won’t hear much about at rallies.
In 2026, the most you can pay out of pocket for covered Part D drugs is $2,100 (7). In 2027, that cap rises to $2,400, and the standard Part D deductible goes from $615 to $700, according to Newsweek (8).
That’s up to $300 more before the cap kicks in, and $85 more before your plan starts paying under the standard deductible.
If drug costs are squeezing your budget, look for savings wherever you can find them.
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4. Check your plan before Dec. 7
CMS says Oct. 15 to Dec. 7 “is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs” (3).
Don’t assume this year’s plan is still your best fit for next year, especially with the cap and deductible going up.
Compare plans at Medicare.gov or by calling 1-800-MEDICARE (3). Have your actual prescription list in hand when you do.
5. Build drug costs into your retirement plan
Even with a cap, prescription drugs are a real line item in retirement, and the cap itself keeps moving.
If you’re trying to figure out how health costs fit with your withdrawals, taxes and Social Security, it’s worth getting a second set of eyes.
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My honest take
Trump deserves credit where it’s due. Medicare is paying less for some expensive drugs, and some patients are saving real money.
But “lowest drug prices anywhere in the world” isn’t what the research shows, and it’s not what many retirees will see on their pharmacy receipts.
The number that matters isn’t the one in a speech. It’s what you’ll pay next year under your plan. Spend an hour comparing before Dec. 7, and you’ll know.
Sources: 1. FactCheck.org; 2. The White House; 3. CMS; 4. CMS; 5. NPR; 6. RAND; 7. CMS; 8. Newsweek
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