(The Epoch Times)—Prescription drugs cost more in the United States than anywhere else in the world. President Donald Trump and some bipartisan senators want to change that.
Trump has so far issued several actions related to prescription drug prices. The latest, announced May 12, is a Most Favored Nation Prescription Drug policy, requiring pharmaceutical companies to offer their lowest price to U.S. customers.
An earlier order aimed to ensure that the middlemen in the drug supply chain can’t hold on to rebates provided by pharmaceutical companies and instead must pass savings on to Medicare beneficiaries.
In all, the president has taken at least a dozen actions to reduce prescription drug costs, while no less than nine Senate bills aim for the same results.
Some of these ideas have been introduced before.
Trump’s Most Favored Nation pricing plan was introduced near the end of his first term.
The plan was stalled by court challenges, and President Joe Biden dropped it shortly after taking office.
A plan to make vendors pass manufacturer discounts on to Medicare beneficiaries was proposed in 2020. Biden rescinded it before it took effect.
There have been modest successes, including a pilot program begun by Trump in 2020 to cap insulin costs for Medicare Part B beneficiaries at $35 per month. At the time, a single vial of insulin cost about $100 in the United States.
That program was a success, and the idea was later broadened to include all Medicare beneficiaries through the Inflation Reduction Act of 2022. By 2024, most major drug companies had voluntarily limited out-of-pocket expenses for insulin for all U.S. customers to $35.
Yet Americans still pay nearly three times as much for prescription medication as any peer nation, often even more.
Trulicity, a medication for Type 2 diabetics, was listed for $67 in France, according to a 2021 Government Accountability Report. In the United States, it cost $798.
Meanwhile, Remlivid, an oral cancer medication, was listed for $4,723 in Australia. In the United States, it was listed at almost five times that price: $22,048.
Why? One answer is that other governments leverage the power of their national health plans to control pricing, while the United States lacks a comprehensive national prescription drug strategy.
The solution, according to at least one senator, is to stop putting patches on a broken system and take a comprehensive approach to regulating the entire pharmaceutical supply chain.
How Others Do It
Some nations can negotiate low prices for prescription drugs because they have national health care plans, which gives them near complete control over the drug market. Here’s how that works for some, according to the Government Accountability Office.
Australia
Australia has a national health care system that is partly administered by state, territorial, and local governments.
Prescription drug pricing is set at the national level, starting with an assessment of the drug’s value. That assessment is made by Australia’s independent Pharmaceutical Benefits Advisory Committee, which evaluates new drugs for cost-effectiveness and may recommend them for inclusion on the list of approved medications under the national health plan.
That decision is made by Australia’s national minister of health, who then negotiates with the manufacturer to determine a price. Among other considerations, the health minister evaluates the impact of adding the drug on the country’s budget.
Canada
Canada keeps prescription prices low in two ways. First, Canada’s federal government sets a maximum allowable price for each medication. The government bases this price, in part, on the therapeutic value of the drug. That value may be higher if the drug is the first of its kind, or lower if there are similar drugs already on the market.
Second, the country’s 13 provincial and territorial health plans negotiate pricing jointly with manufacturers, combining the power of their respective markets.
France
France has a national health care system that includes prescription drugs.
The French government negotiates prices with manufacturers based on an assessment of the therapeutic value of the drug. The country also places a cap on total prescription spending.
The Drawbacks
These arrangements significantly lower prescription costs for the government and for patients. But there are drawbacks.
When a U.S. insurance company can’t negotiate an acceptable price from a drug manufacturer, the insurer may choose not to cover the drug. However, another company will often cover it, so patients still have options.
However, when a drug is omitted from a national health plan, it may be more difficult to find it or afford it anywhere in that country.
For example, Signifor, a drug used to treat hormonal diseases, was not available in Ontario, Canada, according to a 2021 study by the Government Accountability Office. Some forms of diabetes drug Trulicity were not available in Australia. Cancer medicine Revlimid 5 milligram and 10 milligram capsules were not available in France.
Or, drugs left off the national coverage list may still be available, but at a higher price.
Drug shortages are another problem.
In countries with national health plans, pharmaceutical companies have less incentive to ensure supply. Companies will favor markets where there is more potential for profit.
“[Drug] shortages are a natural outcome of imposing prices divorced from free market processes,” Jeremy Nighohossian, a senior fellow at the Competitive Enterprise Institute, a libertarian think tank, told The Epoch Times.
Stephen Ubl, president and CEO of Pharmaceutical Research and Manufacturers of America, said, “Importing foreign prices from socialist countries would be a bad deal for American patients and workers,” in a May 12 response to Trump’s plan.
“It would mean less treatments and cures and would jeopardize the hundreds of billions our member companies are planning to invest in America—threatening jobs, hurting our economy and making us more reliant on China for innovative medicines.”
The US System
In the United States, various government agencies, private health plans, and commercial insurance companies each take their own approach to controlling prescription costs.
The Inflation Reduction Act of 2022 authorized Medicare to negotiate prices with insurance companies.
Those negotiations resulted in price reductions of roughly 40 to 80 percent for 10 medications, effective in 2026. Fifteen more discounted drug prices will go into effect in 2027.
However, all these medications are of a lesser-expensive type known as small-molecule drugs, according to C. Michael White of the University of Connecticut School of Pharmacy. None of the more costly large-molecule drugs used to treat cancer and other diseases were discounted.
White thinks greater savings are possible. “Private insurers negotiate the price of all drugs with manufacturers, so why is the federal government only negotiating a handful each year?” he told The Epoch Times.
Insurers generally outsource prescription drug negotiations to pharmacy benefit managers. These companies both negotiate prices and process pharmacy claims for insurers.
In theory, this should result in lower prices for consumers and greater efficiency for insurers, but that’s not always the case, according to Sen. Chuck Grassley (R-Iowa).
Pharmacy benefit managers “exercise growing influence on prescription drug supply chain,” Grassley told a Senate Judiciary Committee hearing on pharmaceutical competition May 13.
“As the middleman, they determine what medications a patient can use and how much the patient pays at the pharmacy counter.”
While pharmacy benefit managers claim to lower costs, Grassley pointed to what he called “opaque” business practices, saying the profits made by pharmacy benefit managers have increased “in ways that don’t add up based on the services they provide.”
Grassley has introduced a bill to require pharmacy benefit managers to be more transparent about drug prices and service fees.
Patches Versus Holistic Approach
Policymakers generally agree that high drug prices are a problem, yet there is no consensus on how to solve it.
Sens. Josh Hawley (R-Mo.) and Peter Welch (D-Vt.) introduced legislation on May 5 to accomplish something similar to Trump’s plan, compelling drug makers to offer lower prices in the United States.
The Republican budget reconciliation bill now being debated also includes provisions to make drug pricing more transparent in the Medicaid system.
This scattershot approach won’t work, according to Sen. Thom Tillis (R-N.C.), who believes Congress must step back and evaluate the entire medication supply chain to decide “how we ultimately address this problem.”
“All these other things are short-sighted, unsustainable measures that are not going to produce the result,” Tillis said on May 13.
Under Trump’s Most Favored Nation Prescription Drug policy, the first round of target prices is set to be delivered by Health and Human Services to pharmaceutical makers by June 11, aiming to align American drug prices with those of comparably developed nations.
Two Storms, One Harvest
Every food crisis in living memory has been a one-shock event. The 2008 price spike was a commodity bubble. The 2020 shortages were a logistics failure. The 2022 grain scare was a war on one exporter’s ports. Each time, the system bent, adjusted, and recovered, and each time the experts assured us afterward that global markets are simply too big and too diversified to fail.
What nobody in Washington seems eager to discuss is that 2026 is shaping up to be something the modern food system has never actually faced. Two independent shocks, one climatic and one geopolitical, are converging on the same harvest cycle at the same time. Not sequentially. Simultaneously.
Start with the weather. The Pacific Ocean is currently building toward what forecasters now openly call a record event. NOAA’s Climate Prediction Center puts the odds of at least a strong El Niño near 88 percent, with roughly two in three odds it reaches “very strong” status, the tier reserved for perhaps three or four events in the entire satellite era. Every major global model now projects a median peak in Super El Niño territory, and most of them project it exceeding the 2015-16 event, which until now held the modern record. Sea surface anomalies were already brushing the super threshold in mid-July, months before these events normally peak. The atmosphere has already shifted into El Niño mode, and the event is forecast to crest in late fall and early winter.
This is not about “climate change.” It’s about the standard cycles of weather, and the cycle we’re currently in is one that has likely devastated societies in the past. We’re better prepared as a society today, but not all Americans are equally prepared.
Serious households have started doing the quiet math on their own. Grocery bills tell part of the story, and the forecast maps tell the rest, which is why long-term food storage has moved from fringe hobby to mainstream line item in the family budget, with established suppliers like Heaven’s Harvest seeing demand from people who five years ago would have rolled their eyes at the idea. That instinct is not paranoia. It is pattern recognition, and the pattern is worth walking through carefully.
Editor’s Note: Heaven’s Harvest IS a sponsor, but the warnings of this article are real and would be written even if we didn’t have a survival food sponsor. With that said, those who take advantage of what they offer can use promo code “Patriot” for 15% off.
The Fertilizer Clock Is Already Running
While the Pacific warms, the second shock has been unfolding in the Strait of Hormuz. The conflict with Iran turned the world’s most important energy chokepoint into a contested waterway, and the consequences reach far beyond the gas pump. Roughly a third of global fertilizer trade moves through Hormuz, and the disruption sent urea prices up 86 percent year over year by March, with a 53 percent jump in a single month.
The World Bank projects energy prices rising about 24 percent in 2026 and fertilizer about 31 percent. By its own accounting, fertilizer prices ran 35 percent higher in the first five months of this year than the same period last year.
Here is the mechanism the nightly news will not explain. Fertilizer is not a grocery item. It is a time-delayed input. The nitrogen a farmer in Iowa or Punjab could not afford to apply this spring does not show up as a problem this spring. It shows up as a thinner harvest six to twelve months later.
The World Bank’s own food security brief concedes that the effects of reduced applications earlier this season “are likely to become visible only later in harvest outcomes.” Translate that from institutional language into plain English and it means this. The damage is already done, it is already in the ground, and we are simply waiting for it to arrive on the shelf.
Now check the calendar. Six to twelve months from the spring planting season lands us squarely in late 2026 and early 2027. Which is precisely when the strongest El Niño in the instrumental record is forecast to peak, bringing its signature droughts to Southeast Asia, Australia, southern Africa, northern Brazil, and South Asia, the very regions that grow the world’s rice, sugar, and oilseeds.
The World Bank warns openly that a strong El Niño “could disrupt multiple crop belts simultaneously” on top of the conflict-driven input costs. Their baseline projection assumes the Middle East disruptions ease by autumn. What in the last two years of Middle East history suggests that assumption is safe?
The System Has No Slack Left
The comfortable answer is that global markets always adjust. But adjustment requires slack, and the slack is gone. Global cereal production is expected to decline from last year’s records even before El Niño does its work. The UN World Food Programme, hardly a den of right-wing preppers, is calling this the most significant disruption to its supply chains since Covid and the invasion of Ukraine, and its supply chain director put the stakes bluntly.
Today’s supply chain challenges are tomorrow’s hunger crisis.
There is also a political dimension that markets cannot price. When food gets scarce, governments do not behave like economists. They behave like politicians. Export bans, hoarding mandates, and panic buying at the national level turned the modest rice shortfall of 2008 into a global crisis, and analysts are already warning that import-dependent nations are the first dominoes.
The 2015-16 Super El Niño, a far weaker event than what is now forecast, threw tens of millions into food stress across Africa and Asia. This one is projected to be stronger, and it arrives with fertilizer already rationed by price and shipping lanes already contested by missiles.
What Joseph Knew
Scripture does not treat preparation for lean years as faithlessness. It treats it as wisdom delivered in advance to those willing to act on it.
Behold, there come seven years of great plenty throughout all the land of Egypt: And there shall arise after them seven years of famine; and all the plenty shall be forgotten in the land of Egypt.
Joseph did not respond to that warning with a hashtag or a committee. He stored grain during the years of abundance, and when the famine came, Egypt stood while its neighbors begged. The lesson is not that famine is certain. It is that the time to prepare is precisely when preparation still looks optional.
Nobody who filled a pantry in a year of plenty has ever regretted it, and nobody standing in an empty aisle has ever been glad he waited for certainty.
None of this calls for panic, and panic is the enemy of sound judgment anyway. It calls for the same unglamorous prudence our grandparents considered ordinary. Keep some cash margin, know your local growers, and put real food in deep storage while it is cheap and available, because the entire arc of this story is that cheap and available is a closing window.
Families looking for a straightforward place to start can visit Heaven’s Harvest and use promo code Patriot for 15 percent off long-term storable food. The forecasts may yet soften, the strait may yet reopen, and we should pray they do. But hope is a fine thing to hold and a foolish thing to eat.
I have a suggestion. Why not make the drugs $67 in the U.S. and $798 in Frances. Those moochy anti-American French can take it up with their sissy president Macron and his teen-assaulting husband.