In a landmark deal announced last week, President Donald Trump negotiated dramatically lower costs for weight-loss drugs produced by pharmaceutical giants Eli Lilly and Novo Nordisk, which could benefit Medicare and Medicaid patients, as well as Americans paying out of pocket. But here’s the skinny: What the president negotiated should not be reserved for big companies that play his game.

GLP-1 medications, including Wegovy and Zepbound, currently have a list price of more than $1,000 for a month-long supply. Trump’s deal would bring that down to $350 on average, and as low as $50 for those who have a co-pay. That could benefit millions of Americans: More than 1 in 10 American adults have tried a weight loss drug, and millions more are interested in doing so.

While specific details of Trump’s deals with Eli Lilly and Novo Nordisk have not been made public, the crux is tariff relief in exchange for lower prices. Both companies have said they will be exempt from Trump’s 100 percent tariff on pharmaceutical imports for the next three years. The companies have also received a promise of priority review for their drugs by the Food and Drug Administration.

To anyone who doesn’t like the idea of tariffs jacking up drug prices or bureaucratic hurdles to new pharmaceuticals, these are obviously good ideas. So why not give them to all drug companies to bring down costs across the board?

The reason is because Trump wants these companies to offer their products on TrumpRx, which is his vision for a government-run website that delivers direct-to-consumer drug sales at highly discounted rates. The platform is a backdoor attempt at pegging drug prices in the United States to the lower levels seen in other developed countries — known as “most-favored nation” pricing, something Trump tried and failed to implement in his first term. Participation is voluntary on the part of manufacturers, but Trump believes he can use his tariffs and other incentives to jawbone them into dealing with the government.

Involving the government in the pricing of medicine might seem appealing based on the European experience, where socialized systems such as Britain’s National Health System negotiate reduced rates because they are buying in bulk for the nation. But it also means bureaucrats get a much bigger say in who can access those drugs, often resulting in strict rationing. In the U.S., for instance, insurance tends to cover weight loss drugs for anyone with a BMI of 27 to 30 and an additional weight-related health condition. In the U.K., your BMI must hit 40, and you must have an additional four health conditions, to become eligible.

Creating a federal system to market cheaper drugs is a surefire way to make CEOs bend to the will of politicians. But Republicans will come to regret their party’s attempt to further centralize commerce. It’s easy to imagine a future Democratic president using the TrumpRx precedent to force companies to adhere to their own ideological agenda. That could be a disaster for innovation and consumer choice.

If Trump wants to stamp his name on something, let it be on a piece of legislation that cements incentives for companies to drop their prices, rather than a website that empowers him to pick and choose corporate winners.

— The Washington Post