As "TrumpRx" Launches, Let's Take A Look At America's Prescription Drug Crisis
Arevalo | CLMI
Imagine a world in which essential medications came with prices so high that they could devastate a family’s finances. This all captures the reality of the American healthcare system, where - among other challenges - skyrocketing prescription drug costs disrupt the economic outlook for countless families. It factored into a bitter and hyper-partisan clash between policymakers over healthcare that resulted in the longest federal government shutdown in American history.
The U.S. healthcare system is characterized by tri-brid structure, which combines private insurance, government programs such as Medicare and Medicaid, and out-of-pocket payments, all of this leading to various regional variations. It features high costs and uneven access, acutely affecting low-income and vulnerable populations. Additionally, healthcare regulation is decentralized, resulting in differing standards across the states. While the U.S. excels in medical innovation with advanced treatments and research facilities, it also faces challenges regarding affordability and equity, fueling ongoing debates about the system’s effectiveness and sustainability.
Affordability concerns among Americans are clearly evident. As GoodRx surveys show, 35% of Americans were highlighting prescription drugs as a “minor burden,” an increase from 30% in 2024. A combined 33% surveyed found prescription drug costs ranging from “moderate to catastrophic” …
Interestingly enough, prescription cost concerns outweighed other costs in the survey …
Those concerns seem warranted, considering manufacturers were increasing prices in 2025, despite projections that the costs would moderate and flatten by 2030. According to a report released in October by the Institute for Clinical and Economic review, there was an increase of 51% in the “median net launch price for 154 new drugs … 2022 and 2024, after accounting for inflation and discounts.” It also discovered a 24% increase (inflation-adjusted) in that same timeframe.
However, drugmakers look to price hikes to grow profits. While previous costs hikes were 9%, a 4.5% increase (while seemingly nominal to manufacturers) can still represent an unsustainable hit to consumer pockets, particularly moderate-to-low income consumers relying on Medicare …
Concerns over the political implications of a prescription price hike in its first year, and what those developments could mean for Republicans in the 2026 midterms, are stressed by where voters might rank prescription drug prices compared to other issues - especially senior voters. In fact, healthcare does rank third among the top 15 issues highlighted among current voters and 2024 election voters …
The Trump administration could then be responding to the politics, rolling out its new “Trump Rx” concept in a bold bid to lower prescription drug costs. But how exactly will that work considering the current and very complex prescription drug landscape? It’s a one-size-fits-all scheme designed to negotiate different terms that could, possibly, force manufacturers to reduce drug prices. Recently, the Kaiser Foundation summarized what that would entail …
Amid perennial public concern about the cost of prescription drugs, the Trump administration has undertaken a raft of efforts to push or persuade drug manufacturers to lower drug prices. These include “Most Favored Nation” proposals that would tie U.S. drug prices to the lowest cost in other countries and encouraging manufacturers to make more drugs available for sale directly to consumers at discounted prices. To date, the administration has inked two voluntary deals with pharmaceutical companies to sell drugs to the Medicaid program at most-favored nation pricing and launch new drugs in the U.S. at the same price as in other countries in exchange for a three-year reprieve from new tariffs on their products. The administration also is setting up a website, Trumprx.gov, scheduled to launch in 2026, through which it plans to connect consumers to manufacturers and other vendors enabling direct-purchase of prescription drugs.
US Healthcare Costs Compared To Other Countries
Prescription drug spending underscores the significant imbalance between the U.S. and other nations such as Germany, France, the United Kingdom, and Japan. In 2019, the U.S. spent $1,126 per capita on prescribed medicines, whereas these other countries averaged $552. Spending in the U.S. surged by 69% from 2004 to 2019, while these nations experienced an increase of only 41%.
In addition to high overall costs, Americans encounter greater out-of-pocket expenses for prescription drugs. Approximately 21% of adults report not having filled a prescription due to cost, and 23% opted for over-the-counter alternatives instead. Notably, around one in seven adults admitted to cutting pills in half or skipping doses over the past year, and about a third of adults employed at least one cost-saving strategy.
These national trends are reflected at the state and local level, where households face similar financial pressures.
Case Study: Economic Issues In California & San Diego County
In California, the financial strain of healthcare is widely felt. A California Health Care Foundation survey found that 53% of Californians have skipped or postponed care due to costs, and 41% carry medical debt. These challenges are particularly pronounced among lower-income households and minority populations, with 60% of Black adults and 65% of Hispanic adults reporting difficulties with affording care. That’s above the national average …
In 2023, the Foundation also reported that 52% of Californians skipped or delayed care in the previous 12 months due to expense, regardless of income level.
San Diego County also reflects these broader state trends. According to the San Diego Foundation, roughly 335,000 residents lived below the poverty line in 2021, about one in ten.
Potential Solutions for America and Local Applications
Researchers have proposed a variety of strategies to address healthcare costs in the U.S. For example, experts at the 2024 Stanford Institute for Economic Policy Research Summit recommended small-scale pilots of “universal basic care” models through programs such as Medi-Cal or nonprofit hospitals, allowing policymakers to test approaches before scaling up.
Amy Finkelstein, an economics professor at the Massachusetts Institute of Technology, summarized the radical 2-part fix that she and Liran Einav, a SIEPR senior fellow and chair of the economics department in the Stanford School of Humanities and Sciences, detailed in their 2023 book, We’ve Got You Covered: Rebooting American Health Care: Guarantee consumers automatic and free basic level of essential medical services, but also the option of buying supplemental insurance for a higher level of care.
Finkelstein emphasized that their proposal, while politically infeasible in the short run, simply codifies what already exists.
“The history of U.S. health policy, as well as our current policies, makes very clear that there is an unwritten, but very real, social contract to provide access to essential medical care regardless of resources,” she said.
Other experts, writing in the Health Management, Policy and Innovation Journal, argue for systemic reforms to improve efficiency and affordability, including …
Shifting payment models to reward results rather than procedures.
Operate healthcare delivery systems with competitive efficiency.
Require industries to compete in improving health outcomes at lower costs.
Draw lessons from successful employer-based and government-run health systems.
Conclusion
Healthcare in San Diego County and beyond, statewide and nationally, highlights both economic and human challenges. Rising costs not only prevent families from filling prescriptions, but also force difficult choices about whether to seek care at all. While the U.S. spends more on prescription drugs than other nations, the financial burden on households often remains high.
Addressing these challenges requires sustained attention, data-driven analysis, and ongoing policy experimentation to ensure that solutions are effective and equitable.
ISABELLA AREVALO is a Fellow at the Civic Literacy and Media Influence Institute at Learn4Life
