Americans typically pay as much as four times more for popular prescription drugs as overseas consumers. Both Trump and former President Joe Biden have sought to rectify the issue, although in different ways.

Trump’s most favored nation deals, unique to each pharmaceutical company, will see drugs offered to state Medicaid beneficiaries or customers of TrumpRx.com at the same levels as the lowest priced overseas.

Biden’s drug pricing vehicle, meanwhile, was much narrower in scope and relied on a law allowing Medicaid to directly negotiate the price of certain drugs with pharmaceutical companies. The former president only secured agreements on 10 specific drugs during his term. The downward price movement, estimated around $6 billion by the Biden administration, did not substantively move the needle for Democrats in either the 2022 or 2024 election cycles.

One senior Biden White House official told the Washington Examiner that the positive action they “delivered” was not enough to overcome inflation and other similar problems now facing Trump and the GOP.

“The overall U.S. healthcare system is broken, and almost everybody who has to interact with it leaves very upset,” the official said. “And so even if you do make important gains for people, they are still going to be thinking about the overall healthcare picture. That’s also a big part of what’s working against Republicans in power now.”

One former Health and Human Services official from Trump’s first term similarly touted the substantive cost savings Trump’s approach is delivering for consumers, but doubted if it could overcome a bad political environment.

“I think in an ideal world, with an unbiased press, this would be getting the proper coverage it deserves. We’ve never seen a politician, let alone a president, stand up to Big Pharma and say, ‘Hey, you’re going to quit screwing over the American people or else’ and actually get results,” that person told the Washington Examiner. “But that’s not the world we live in. I kind of think that the public’s made up its mind at this point, and nothing that President Trump or Republicans say will change that.”

A May poll by the Kaiser Family Foundation found that just 41% of respondents believed Trump’s policy would drive down prescription costs, including only 35% of independent voters. The same poll found that 38% trusted Democrats more on lowering prescription costs, compared to 28% for Republicans and 27% who said they trusted “neither party” on the issue.

Yet, a June 2026 survey conducted by a Democratic polling group found that a majority of respondents support codifying Trump’s most favored nation drug policy into law, which the president has argued is necessary to prevent rollback from future administrations.

Despite the mixed polling, Republicans are leaning into the topic as a midterm talking point.

“For decades, Big Pharma dictated prices to the American people, causing the cost of lifesaving medicine to skyrocket,” Republican National Committee spokeswoman Delanie Bomar told the Washington Examiner. “But now, Republicans are taking the fight to Big Pharma by offering policies that drastically lower the cost of prescription drugs, while Democrats want to take away rural hospital funding and hand out taxpayer-funded gender transition surgeries.”

Buoying the GOP’s case is that the consumer price index for August showed prescription drug prices fell by more than 3% over the past year.

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Democrats, however, say any positives drawn from Trump’s prescription drug deals won’t be enough to overcome more than a year of Democratic attacks over the people kicked off Medicaid by the GOP’s new work requirements for the program.

“Your record is solidified well before before November,” a Democratic strategist said.