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- By Elyse Wild
A Trump administration plan to slash prescription drug prices by tying them to international markets will likely have minimal impact on Indian Country, according to a tribal health leader who called the initiative well-intentioned but ineffective.
President Donald Trump announced on Monday, May 12, a plan to lower prescription drug prices in the U.S. by tying prices to markets in other countries.
Ester Lucero (Diné), president of the Seattle Indian Health Board, told Native News Online the executive order lacks enforcement mechanisms to create meaningful change for Native communities.
“I think there is a lack of understanding of how the system works,” she said. “These manufacturers would have to opt in, and so there really is no teeth to that because opting in would basically reduce their profits, and it also skirts (a program) that already exists, the 340B program.”
The executive order claims the “most-favored nation policy” will cut drug prices by 59% by addressing what Trump called a pricing imbalance where U.S. consumers subsidize discounts for other nations, despite representing less than 5% of the world’s population.
The 340B program already requires pharmaceutical companies to provide steep discounts to healthcare organizations serving low-income or underserved populations, such as the Indian Health Service, tribally owned and operated pharmacies, and Urban Indian Health Programs.
“I don’t imagine we would see massive change within Indian Country,” Lucero said.
A 2002 study showed that 84% of Native Americans, who face health disparities nearly across the board for chronic disease, take prescription drugs.
Lucero suggested that requiring Medicaid to cover higher-cost medications would be more effective for Indian Country. She pointed to Ozempic — a Type-2 diabetes drug highlighted in Trump’s announcement — as an example where insurance limitations, not just pricing, create barriers.
“The reason that it’s not accessible is because insurance companies are refusing to pay for it, so it’s only available to folks who can pay out of pocket,” she said. “So if you’re not going to demand that insurance allow for higher cost meds right in their billing platform, then it’s never going to work. Medicaid is where folks who need access to these meds are being limited.”
Within a month, the Department of Health and Human Services must provide most-favored-nation price targets to drugmakers. If the move fails, HHS Secretary Robert F. Kennedy Jr. will be required to propose regulations to implement most-favored-nations pricing.
Despite her skepticism, Lucero acknowledged one positive aspect: “What I do like about this executive order is the idea behind making drug prices transparent,” she said.
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