Trump has signed four executive orders to improve the affordability and accessibility of life-saving drugs like insulin. However, the state of the fourth and most impactful order is unclear.[cite]President Donald J. Trump Is Taking Action to Lower Drug Costs and Ensure That Americans Have Access to Life-saving Medications. NPR.Org.[/cite][cite]Trump Signs Executive Orders On Drug Prices. NPR.Org.[/cite]

The first order directs health centers to pass along discounts on insulin and epinephrine received from drug companies to certain low-income Americans.

The second order allows for the importation of certain drugs and allows for the re-importation of insulin products made in the US.

The third order prohibits secret deals between drug makers and pharmacy benefit manager middlemen to stop certain types of price gouging.

The fourth helps the US pays the lowest price available in economically comparable countries for Medicare Part B drugs.

With that in mind, the fourth order (also the most impactful and potentially wide reaching) may not be implemented. The official White House briefing said that all orders were signed, but it is unclear if it was actually signed. Further, it seems Trump will meet with pharmaceutical industry executives on Tuesday, which may shape the fourth order or may influence whether it comes out or not.

Regardless, the other orders on lifesaving drugs like insulin and epinephrine is a welcome change for advocates of fair pricing for life saving drugs. So while some may take issue on this set of orders not going far enough, especially if the fourth is toned down or left out, the first three are impactful and likely to be universally applauded.

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