TrumpRx and Cost Plus Drugs Are Reshaping How Americans Buy Prescriptions. Here Is a Publicly Traded Way to Follow the Trend.

Why NIA has invested in Medicure (TSXV: MPH), owner of Marley Drug, as cash-price pharmacy goes mainstream.

Healthcare is one of the costs that hits American households hardest, and prescription drugs are a big part of it. Two recent developments are changing how patients shop for medication: the launch of President Donald Trump’s TrumpRx.gov and the rapid growth of Mark Cuban’s Cost Plus Drugs.

The two men are political opposites. Even so, both are pushing the same idea: patients should be able to see cash prices and compare them. We believe this shift toward price transparency is one of the most important trends in healthcare, and it is one of the main reasons we have invested in Medicure (TSXV: MPH), which owns the online pharmacy Marley Drug.

Two New Trends: TrumpRx and Cost Plus Drugs

• TrumpRx launched on February 5, 2026 with about 40 drugs. After two expansions in May and June, it lists more than 800 generics, in addition to its brand-name offerings.
• Cost Plus Drugs launched in January 2022 with 111 medications. It now offers thousands of products.

The two are not really competitors. In May, TrumpRx began integrating prices from Cost Plus Drugs, Amazon Pharmacy and GoodRx, and it sometimes routes users directly to those services. TrumpRx is not a pharmacy itself. It points patients to manufacturers’ direct-to-consumer sites, coupons and partner pharmacies.

Cost Plus Drugs has made affordable medication a mainstream conversation. It is still privately held, though. If Cuban ever takes it public, we believe it could draw a multi-billion-dollar valuation. Until then, investors who want exposure to this trend have few public options. One of them is Medicure.

Where Medicure’s Marley Drug Fits In

Medicure Inc. (TSXV: MPH) owns Marley Drug, a licensed U.S. mail-order pharmacy that serves patients nationwide. Medicure says its strategy is to offer products to patients outside the traditional insurance channels. It started with its own cardiovascular product, Zypitamag. It has said that this success has attracted other drug makers who want to distribute through Marley Drug.

Two examples show how Marley compares with the other cash-pay options.

Example 1: LODOCO® (low-dose colchicine)

LODOCO was approved by the FDA in 2023. It was the first anti-inflammatory drug approved in the U.S. to reduce the risk of cardiovascular events such as heart attack and stroke in eligible adults. In the LoDoCo2 trial, low-dose colchicine was associated with a relative reduction of about 31% in the primary composite cardiovascular endpoint compared with placebo.

Prices vary widely by pharmacy. We compared the cash price of LODOCO 0.5 mg (30 tablets) on November 1, 2026:

The manufacturer, Agepha Pharma, names Marley Drug and BlinkRx as mail-order options for LODOCO. According to Agepha, eligible commercially insured patients may pay as little as $10 per month. Eligibility rules and restrictions apply.

Example 2: Brenzavvy® (bexagliflozin), a head-to-head with Cost Plus Drugs

Brenzavvy belongs to the same drug class (SGLT2 inhibitors) as Jardiance and Farxiga. It helps the kidneys remove excess sugar through urine, which lowers blood sugar without relying on insulin. The FDA approved it in 2023 for adults with Type 2 diabetes. It is positioned as a lower-cost option for people who are uninsured, underinsured or paying cash.

The market is large. Medicure has pointed to roughly 37 million Americans living with Type 2 diabetes, and it describes the U.S. SGLT2 market as worth about $26 billion. It has also cited data suggesting that more than 25% of potential SGLT2 patients cannot access these drugs because of cost or limited insurance coverage.

Brenzavvy’s distribution information names two key partners, Mark Cuban’s Cost Plus Drugs and Marley Drug:

Cost Plus Drugs has advertised a lower listed price. But the listed price is not what the customer pays. Shipping and fulfillment fees change the final cost, and delivery speed matters to patients who need their medication on time.

*Launch pricing announced by TheracosBio in July 2023. Prices, fees and delivery times change and depend on the prescription, destination and processing requirements. Please check each pharmacy’s website for current details.

Once shipping is included, the price gap may be smaller than it looks. Marley’s free shipping and fast delivery could be a real competitive advantage, because in this market convenience can matter as much as the sticker price.

Marley Drug Also Works With Other Platforms

Marley Drug does not rely only on direct customers at MarleyDrug.com. Medicure has announced a partnership with the prescription savings platform RxSpark, under which Marley Drug is the exclusive mail-order pharmacy. This shows that Marley can fulfill prescriptions for other healthcare businesses, not just its own customers.

Could Marley Drug Join TrumpRx?

TrumpRx already draws pricing from Cost Plus Drugs, Amazon Pharmacy and GoodRx. That raises the question of whether other pharmacies could be added as the platform expands.

No partnership between TrumpRx and Medicure (TSXV: MPH) has been announced, and there is no assurance one will happen. If one did, we believe it could be a major catalyst for Medicure’s visibility. Marley’s existing fulfillment infrastructure, its low cash price on LODOCO and its experience with third-party platforms make it, in our view, one of the most interesting healthcare companies to watch going into 2027.

Bottom line: TrumpRx and Cost Plus Drugs have turned cash-price transparency into a national story, and patients facing high costs are the beneficiaries. Marley Drug competes in the same space with low cash prices, free shipping, fast delivery and phone support, and it is owned by a publicly traded company. That is why NIA has invested in Medicure (TSXV: MPH). Do your own research before making any decision.

Disclosure: Past performance is not an indicator of future returns. NIA is not an investment advisor and does not provide investment advice. Always do your own research and make your own investment decisions. NIA’s President has purchased 87,000 shares of MPH and intends to buy more shares. This message is meant for informational and educational purposes only.