Fertility treatment given special emphasis as Trump Rx site goes live

TrumpRx, the US president’s much-anticipated drug discount program, went live earlier this month with coupons available for just 43 medications, including four required for in vitro fertilization (IVF) procedures, and experts say this is probably a half-measure to fulfill Trump’s 2024 campaign promise to make IVF treatment universally accessible.“We’ve been hearing about TrumpRx for a long time,” said Dr Richard Paulson, a professor of reproductive medicine at the University of Southern California. “TrumpRx was supposed to fix all of the problems in terms of prescription drug costs and so on, and it has not done that. The only two classes of drugs that are actually cheaper on Trump RX are the GLP-1 agonists – those are the obesity medications – and fertility drugs.”There is a search function on the TrumpRx website, but most Americans are unlikely to type in their prescription medications and see results. Medications for fertility, weight loss and menopause are overrepresented. Patients can print out coupons from the TrumpRx website or add them to their digital wallets, similar to other discount services like GoodRx.com. The White House has said additional drug discounts will become available on the platform in coming months.But the fertility drug coupons only account for a fraction of the cost of IVF treatment, says Sean Tipton, chief advocacy and policy officer at the American Society for Reproductive Medicine. Although patient circumstances, location and insurance mean that the calculation is different for everyone, Tipton says “pharmaceutical costs are typically 10 to 20%” of the total cost of IVF, which also includes expenses like egg retrieval procedures that require sedation.The Centers for Medicare and Medicaid Services estimates that TrumpRx discounts will save patients up to $2,200 per IVF cycle, but each cycle can cost as much as $30,000 out of pocket. Many clinics recommend that patients plan to undergo as many as four cycles, as each one only carries a 30% chance of resulting in pregnancy and live birth.The Heritage Foundation, the religious conservative thinktank that authored Project 2025, an agenda that has had extensive influence on Trump’s second-term policies, is generally opposed to IVF, framing opposition as part of the “pro-life” agenda. Tipton said it did not logically follow that opposition to abortion means opposition to IVF.“Pregnancy termination and pregnancy creation are very, very different things,” Tipton said. “However, if you have built your opposition to pregnancy termination on the fiction that a fertilized egg is the same as a baby, then IVF is dangerous to you.”Tipton suspects that The Heritage Foundation’s influence has prevented Trump from taking further steps to expand IVF access. In its January report, entitled “Saving America by Saving the Family: a Foundation for the Next 250 Years”, Heritage Foundation writers argue that embryos are “sacred human beings” and that IVF is therefore ethically questionable, as not all embryos created in the process survive.In an op-ed, Paulson wrote that The Heritage Foundation’s framing ignores the reality that even in the course of natural reproduction, most embryos never become children.Some of the medications listed on TrumpRx could be used either for IVF or for what The Heritage Foundation has labelled “restorative reproductive medicine (RRM)”, which Paulson said is a scientifically dubious term.“It’s deceptive,” Paulson said, because the philosophy behind RRM “is that you need to be restored”.By this logic, “infertility is not a disease, it’s a manifestation of other problems, and you need to fix those problems, and when you do, your infertility will go away”, he said, likening this to other Make America Healthy Again (Maha) logic, such as the idea that diet can fix chronic illnesses.“Eat meat, right? If you just eat red meat, everything’s going to get better,” Paulson quipped, in reference to the health secretary Robert F Kennedy Jr’s refrain about the benefits of protein.The health department did not respond to a request for comment about TrumpRx and its fertility offerings.Alternatives to IVF, like intrauterine insemination (IUI) with fertility drugs, can lead to unwanted results. For example, IUI raises the risk that patients will become pregnant with twins or even more babies at once, which in turn raises the risk of pre-term births and other related problems.Still, Heritage Foundation analysts have stated that they can accept IUI, so long as it only involves the sperm and egg of a married man and woman, while remaining hostile to IVF.Paulson supports individual patients’ right to make medical decisions based on faith, but does not think faith should guide medical policy: “If you start with the Bible and see that as the truth, and then you filter everything through that prism, then you’re going to come up with different conclusions than those people that are just looking at the science, and that’s the problem.”