Affordability is a key talking point for both sides of the political aisle as we head into the 2026 midterm elections. On one hand, President Donald Trump and his senior officials are embarking on an economic road tour, bringing a clear and confident message to battleground states and districts that their record is undeniable and unflappable. On the other hand, Democrats are looking to hide behind four years of economic mismanagement, inflation, and regulatory overreach under the Biden-Harris administration by pointing to the purported shortcomings of Trump’s own fiscal and economic policies.
Despite rhetoric on both sides and, candidly, the very important economic successes from the Trump administration, no serious leader pretends that every problem can be solved overnight. And one issue still weighing heavily on American families is the cost of prescription drugs.
Even with Trump holding Big Pharma’s feet to the fire — demanding transparency, competition, and fairness — millions of Americans, especially seniors and working-class families across America’s heartland and in states like Pennsylvania, where I served in Congress, are still being crushed by high prices at the pharmacy counter. Brand-name drugs remain outrageously expensive, forcing too many Americans to choose between their health and their household budgets.
This is not an accident, and it is unacceptable.
It is the result of pricing practices and a broken pharmaceutical ecosystem designed to protect profits, not American patients. The lack of real competition allows Big Pharma to charge Americans far more than patients pay for the exact same medicines abroad.
Trump and the new Republican leadership in Congress have always understood that competition is the lifeblood of a healthy market. They know that when monopolies are challenged, prices fall and consumers win. That same principle should apply to prescription drugs.
A commonsense, responsible solution is right in front of us: expanding personal drug importation from licensed, tier-one countries — our closest allies with gold-standard safety and regulatory systems. This is not about gray markets or risky shortcuts. This is about enabling American patients, under the oversight of U.S. physicians, to access safe, brand-name medications at dramatically lower costs.
Licensed providers importing drugs from trusted countries would increase competition overnight. It would expand access, lower prices, and deliver immediate relief to American seniors and families who have waited far too long for Washington, D.C. to act.
Just as important, this is smart politics.
Democrats will spend the next year talking endlessly about “affordability” while offering no real solutions beyond more bureaucracy and price controls that stifle innovation. Trump and Republicans in Congress can cut through that noise with action. Supporting responsible drug importation from tier-one countries would neutralize a key Democrat talking point and show voters — especially independents and seniors — that Republicans are delivering real results where it matters most.
Heading into the midterms, this is a clear opportunity for a decisive win. Lower drug prices. More competition. Stronger markets. Happier voters. By embracing drug importation from trusted allies, he can deliver another major victory for patients, for taxpayers, and for the Republican agenda: right when it counts most.
Ryan Costello served as the U.S. Representative for Pennsylvania’s 6th district from 2015 through 2019 as a Republican. During his time in Congress, he sat on the House Energy and Commerce Committee.
