Trump takes aim at prescription drug ‘middlemen’ with new healthcare plan

Trump Takes Aim at Prescription Drug ‘Middlemen’ with New Healthcare Plan

The Trump administration has unveiled a bold new healthcare framework aimed at tackling the escalating costs of prescription drugs and health insurance premiums in America. Dubbed the “Great Healthcare Plan,” this initiative focuses on eliminating kickbacks involving pharmacy benefit managers (PBMs), which the administration claims are largely responsible for soaring insurance costs.

The Issue with Pharmacy Benefit Managers

President Donald Trump announced the new healthcare plan, urging Congress to pass it into law “without delay” to deliver “immediate relief to the American people.” The administration’s proposal describes PBMs as “large brokerage middlemen” who exert significant influence in the pharmaceutical industry.

PBMs act as intermediaries between drug manufacturers, insurers, and pharmacies. They negotiate prices, determine which drugs are covered by insurance, and decide how much pharmacies get reimbursed for medications. Their role in the healthcare landscape has attracted criticism over the years, with many industry experts arguing that PBMs contribute to rising drug prices by extracting excessive profits.

Key Components of the Great Healthcare Plan

As part of its strategy to reduce healthcare costs, the Trump administration’s framework aims to:

• Eliminate kickbacks paid by PBMs, thereby limiting their profit margins and influence.
• Enhance price transparency in drug pricing and insurance premiums.
• Hold large insurance companies accountable for their pricing strategies.
• Provide financial support directly to eligible Americans to facilitate the purchase of their preferred health insurance.

This direct approach to cut PBMs out of the equation is a significant shift from earlier statements made by Trump, where he threatened to eliminate them completely. While this latest proposal doesn’t go as far, it indicates a willingness to reform their role to ensure more manageable drug prices.

Historical Context: The Criticism of PBMs

Pharmacy benefit managers have long been a contentious point in the healthcare debate, receiving pushback from both the healthcare industry and various presidential administrations. Critics argue that the centralization of power within PBMs leads to inflated prices for both consumers and pharmacies. Independent pharmacists often voice grievances about how PBMs impact their operations by reducing reimbursement rates, which in turn affects their bottom line.

The Pharmaceutical Care Management Association, the trade association representing PBMs, counters these claims by asserting that PBMs strive to lower prescription drug costs and act as a necessary check against the pharmaceutical industry’s unchecked pricing power.

Trump’s Vision for Drug Pricing

In his efforts to reduce drug prices, Trump has expressed a desire for the United States to pay the “lowest price there is in the world” for medications. During a May 2025 press conference, Trump stated, “We’re going to totally cut out the famous middleman.” This rhetoric emphasizes the administration’s focus on empowering consumers by facilitating direct access to affordable medications.

Trump has yet to specify how his administration plans to fully achieve these reforms, but the concept of cutting out PBMs has garnered support from several major pharmaceutical companies. For instance, Eli Lilly has acknowledged that reducing the profits of intermediaries is essential for lowering costs for American consumers.

Broader Implications of the Healthcare Plan

The proposal to target PBMs is just one facet of Trump’s broader efforts to rein in healthcare spending. Other key elements of the Great Healthcare Plan include:

• Ending substantial taxpayer-funded subsidies to large insurance companies, redirecting these funds to individuals for purchasing their desired healthcare coverage.
• Implementing a cost-sharing reduction program designed to save taxpayers approximately $36 billion while reducing common Obamacare plan premiums by over 10%, based on Congressional Budget Office figures.

This comprehensive approach reflects an understanding of the multifaceted nature of healthcare costs and aims to empower consumers while reducing wasteful spending in the system.

Conclusion: A Step Toward Greater Transparency and Affordability

Trump’s “Great Healthcare Plan” signals a marked shift in how prescription drug pricing and health insurance are managed in the United States. By targeting pharmacy benefit managers and advocating for increased transparency, the administration hopes to provide relief to millions of Americans burdened by high healthcare costs. The success of this framework will ultimately depend on bipartisan support and effective implementation, but the focus on the role of middlemen in the healthcare system is a significant step toward making medications and insurance more affordable for all Americans.