TrumpRx: Big promises, limited impact

A month after its launch, President Trump's new platform TrumpRx remains far more limited than the sweeping health care overhaul the administration promised. Only 44 drugs are currently listed, STAT's Daniel Payne writes — a tiny fraction of the roughly 24,000 approved medications in the U.S. Nearly half of the drugs listed were already available cheaply as generics.

"For several patients in our community, TrumpRx prices are the same or even higher than what they currently pay with insurance," said Merith Basey, executive director of Patients For Affordable Drugs

The White House has offered little data on how many people are actually using the site, despite earlier promises to release metrics. Online tools that provide Web traffic estimates are known for widely different results, but the trend of declining interest is clear.

FDA

The extremism of the FDA's Marks and Prasad has come with costs

At the FDA, it's become clear that Vinay Prasad, the director of the Center for Biologics Evaluation and Research, and his predecessor, Peter Marks, have diametrically opposed viewpoints when it comes to regulatory philosophies.

For Marks, the emphasis was on maximal flexibility, one might even call it absolute permissiveness, STAT's Adam Feuerstein writes. For Prasad, only drugs that work with certainty should pass muster.

The transition from one to the other has been rocky. "The rare-disease community is suffering whiplash. Drugmakers are frustrated. Investors are sitting on their wallets," Adam writes.

In the latest edition of "Adam's Biotech Scorecard," Adam suggests the two camps meet somewhere in the middle.

glp-1 drugs

Lilly rolls out Zepbound program for employers

Eli Lilly is expanding its direct-to-patient strategy for the obesity drug Zepbound by courting employers with a new payment model that bypasses traditional insurance. The company said this morning a new program will connect employers with third-party vendors, STAT's Elaine Chen writes, letting them subsidize the drug's $449 monthly cash price. This allows companies to chip in a set amount — say $50 or $100 — while employees cover the rest.

Lilly pitches the model as a way to expand access to obesity drugs. But there's concern this could ultimately leave workers paying more out of pocket — and could give employers an excuse to drop obesity drugs from their traditional health plans altogether.

biotech

A drug company with a side of gold?

From STAT's Allison DeAngelis: A small gene therapy company has taken a surprising route in developing medications for ALS and aging-related conditions. Klotho Neurosciences, based in Charlotte, N.C., has bought a controlling stake in a mining corporation. The operation is scraping southeastern Greenland for palladium, gold, and platinum products.

It doesn't appear that Klotho plans to use the metals in its drug development. The company will now have two divisions, one focused on drug development and the other on the Greenland mining project. (The company does note that palladium and platinum are both used in health care devices). CEO Joseph Sinkule said in a statement that the deal will diversify the company — "This is the kind of asset that reshapes a company's trajectory overnight, and our shareholders now have direct ownership in it."

The statement makes no reference to the fact that President Trump has recently expressed interest in gaining access to Greenland's mineral wealth. (Investors generally have taken notice.)

Klotho does need a cash infusion to shore up its balance sheet. The company had around $7 million in the bank, as of November — enough to finance its operations for roughly a year.

opinion

GLP-1s may quiet addiction's underlying noise

GLP-1 drugs such as Ozempic are starting to reshape how scientists think about addiction, physician-researcher Ziyad Al-Aly writes in a new First Opinion in STAT.

Patients have increasingly reported that cravings for alcohol, nicotine, and other substances fade after starting the medications — and emerging research appears to support those anecdotes. In a study of more than 600,000 people, GLP-1 drugs were associated with markedly fewer overdoses, substance-related deaths, and new substance use disorders. Animal studies suggest the drugs blunt the brain's reward response rather than making substances aversive.

"Craving is a biological signal — a drug noise," Al-Aly writes. "We are learning that this noise likely shares a common pathway across substances, one that GLP-1 drugs may be able to quiet. That possibility deserves rigorous trials — and may reshape how we treat addiction. Not one substance at a time. All of them at once. Enough quiet from the drug noise to choose."

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