Growing up in the Kalispell pharmacy her grandfather owned for 45 years, Kimberly Murray watched the price of drugs balloon as patients increasingly absorbed out-of-pocket costs. She has also seen coverage policies change and evolve to reduce those costs, including when the Medicare Prescription Drug Benefit program was launched in 2006. Also known as Medicare Part D, the optional program includes prescription drug coverage in the federal government’s health insurance system.
Today, as the owner of two Flathead Valley pharmacies — Bigfork Medicine in Bigfork and Alpine Apothecary in Whitefish — Murray is once again in the spotlight as the federal government takes another stab at slashing the nation’s steep drug prices with a new, but familiar approach.
In early February, the Trump administration launched TrumpRx.gov, a government website that offers discount coupons for prescription drugs. President Donald Trump has negotiated directly with manufacturers for “best in the country” prices, insisting that the prices are in line with the lowest drug costs in the world, even as a recent New York Times review refuted that claim.
In northwest Montana, pharmacists are looking through websites to find out what this means for their patients as Trump continues to expand the number of specially discounted drugs.
“The site itself is very easy to use,” Murray said.
Patients can search the site for medications and print the corresponding coupons, or save them in a virtual wallet and bring them to the pharmacy. The structure works like GoodRx, a prescription coupon company launched in 2011 that is also a Trump Rx partner.
In addition to the traditional “stick, stick and pour” tasks—licking labels, sticking them on bottles, and pouring pills—Murray and her pharmacists spend much of their time learning the intricacies of patients’ insurance plans and fine-printing coupons. Their goal is to ensure that patients receive the largest discount, while smaller pharmacies receive fair reimbursement.
Patients enrolled in federal or state health insurance are not eligible for some Trump Rx coupons. That includes people who may be eligible for a government plan based on factors like their age or income, even if they’re not enrolled in one, Murray said.
At Bigfork Medicine, Murray said many of the individual patients on Medicare are moving toward an older age demographic and require more expensive prescription drugs.
“This is a population that needs medical care, has multiple diagnoses and is on expensive medications,” Murray said.
Sticker price for other Trump Rx coupons that insured patients are eligible for may offer significant savings. But depending on the patient’s deductible, how many prescriptions they have, and how often they need refills, they may end up paying more in the long run by using coupons than they would if they paid out of pocket.
The government website also recommends that patients check their insurance before using a coupon.
“If people go through these copay cards and don’t pay their insurance, they won’t meet their out-of-pocket maximums and may end up spending more in the long run,” Murray said. “Yes, it’s more expensive through their insurance, but they got (prescriptions filled) twice, they paid higher, and now they’ve spent $2,000 and they’re completely covered in zero copays for the rest of the year.”
Trump Rx coupons also apply exclusively to name-brand drugs, while generic prescription drugs are likely still cheaper than discounts, Murray noted. Sometimes, however, patients cannot use the generic option due to reactions to various bonds or fillers that may be used in cheaper versions of the drug.
“For these people, it’s beneficial. It’s a savings,” she said. “But the percentage of people who can’t buy the generic equivalent of the brand name, the FDA-approved form — after the patent expired and then we had both the brand and the generic — is very small. I’d say less than 3%, and that’s probably being generous.”
Some of the popular drugs listed on TrumpRx are fertility drugs and diabetes drugs, known as GLP-1s and popular for weight loss, including Ozempic, Wegovy and Zepbound. It is often not covered by insurance. For those, the Trump Arcs discounts are significant—for example, the Vigoway doll, which normally has a wholesale price of $1,349, is discounted 78% to 89%.
At Alpine Apothecary in Whitefish, Murray is often asked about the pharmacy’s cash price for Vigoway. He is now able to point to Trump’s arcs discount.
“Now we have a solution for people who think it’s unattainable,” she said.
The website also offers coupons for other prescription drugs, such as hormones and thyroid drugs, in which case it’s more common for people to need brand-name drugs, Murray said.
The number of coupons listed on the government website is still just a drop in the bucket. In about two months, the list has grown from more than 40 drugs to about 60. At her small pharmacy, Murray said she keeps about 160 brand-name drugs in stock and special orders others.
“It has to grow,” she said. “When I go through my catalog for brand-name drugs, there are over 2,800 brand-name drugs that I can get a prescription for.”
Yvonne Christo is president of Sykes Pharmacy, which has locations in Kalispell and Columbia Falls. Under the wing of Greater Valley Health Center, the pharmacy serves a diverse patient population with a focus on the insured and underinsured patient population.
So far, few patients have used government coupons.
“Because Trump’s Rx program is still new, I am uncertain, but optimistic about its effectiveness,” Christo said in a message. Bacon She noted that the Greater Valley also has an inpatient program that allows uninsured or underinsured patients to receive medications at affordable prices.
GoodRx, a Trump Arcs partner, has offered drug discount coupons for years. While it cuts out middlemen to offer patients lower prices, smaller pharmacies like Murray’s have stopped accepting GoodRx coupons. GoodRx’s fees to pharmacies often result in small businesses like hers losing money, she said.
“Our pharmacy doesn’t take it because we can’t afford it,” Murray said. “We can’t go through these prescriptions and lose money on every drug to buy GoodRx.”
When recently running a Trump Rx coupon for a patient who used a GoodRx code for Vigo, Murray noted that Trump Rx coupons don’t charge pharmacy fees but that’s what he’s looking for.
Ken Chatrind, director of pharmacy at the University of Montana Health Center, noted that the problem, negative transfers, is common in programs like GoodRx. Those patients can often find similar or better discounts through the health center’s internal loyalty program, which is often offered by major drugstores, such as CVS and Walgreens.
“They act like internal insurance,” Chatrind said. “However, compliance with this may result in (patients) having a higher deductible, and if they reach that deductible, the drug will be free. If you do the internal system, they will not be delivered, and if you continue to do so, the deductible will not be met.”
Patients can use coupons through TrumpRx in three ways: visiting their pharmacy, going through a specialty pharmacy, or ordering direct from the manufacturer to the consumer. It is the latter, the delivery of medicine to the patient’s home, that worries the mother the most.
“When you have your entire medical profile in one of my pharmacies, we will look at everything in your profile for drug interactions. We will advise you and make sure you fully understand how to take the medicine, what side effects to watch for – any questions, we are a phone call away or you can walk to our door.”
“They don’t have to get counseling with these drugs because it’s the kind of stuff they just buy off the shelf.”
Eliminating all the variables—patient deductibles, prescription requirements, insurance copays, and the fine print that some discount coupons require—Murray and Chatterand work with patients on an individual, case-by-case basis to determine which approach might save patients. They recommend patients discuss their options with their pharmacists to see if using a discount coupon like TrumpRx pays off in the long run.
“Any potential savings that we can get to patients that come from drug manufacturers is beneficial, and that’s where they start. Is it the perfect solution now? Absolutely not,” Murray said. “Does it open the door for more conversations about this? Yes.”
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