When Pres­i­dent Don­ald Trump un­veiled his an­tic­i­pat­ed di­rect-to-con­sumer drug plat­form on Thurs­day, he said he'd done what oth­er politi­cians had promised but nev­er de­liv­ered. "They all failed,” he said. “It was all words as usu­al."

But the pres­i­den­t's new site, TrumpRx, does­n't yet ap­pear to match his promis­es.

On­ly 43 drugs are avail­able on TrumpRx, from about a third of the drug­mak­ers that have agreed to par­tic­i­pate in the pro­gram. In some cas­es, gener­ic ver­sions are avail­able else­where, which are of­ten cheap­er.

“It's most­ly smoke and mir­rors, de­signed to cre­ate the ap­pear­ance of ac­tion when it'll ac­tu­al­ly help few peo­ple,” Ian Spatz, a for­mer pub­lic pol­i­cy ex­ec­u­tive at Mer­ck who's now a prin­ci­pal at Rock Creek Pol­i­cy Group, told End­points News.

The Trump ad­min­is­tra­tion is tak­ing a step back from its planned 340B re­bate pi­lot that a court blocked last month.

HHS asked a Maine fed­er­al court to set aside ac­tions re­lat­ed to the orig­i­nal pi­lot pro­gram and send it back to the agency for re­view. The Thurs­day re­quest marks the end of a hos­pi­tal group's le­gal chal­lenge and sug­gests that the agency will con­sid­er cre­at­ing a new ver­sion of the pi­lot.

The aim of the orig­i­nal pi­lot was to shift the 340B drug pric­ing pro­gram from up­front dis­counts to a re­bate mod­el. In a joint mo­tion filed Thurs­day, at­tor­neys for HHS and the Amer­i­can Hos­pi­tal As­so­ci­a­tion wrote that if the agency de­cides to be­gin a new re­bate pro­gram, it will is­sue a new no­tice, so­lic­it new ap­pli­ca­tions, and so­lic­it com­ments “ei­ther pri­or to or con­cur­rent­ly with a new no­tice, or both."

The FDA can con­tin­ue to grant sev­en years of ex­clu­siv­i­ty for or­phan drugs with new in­di­ca­tions, as Pres­i­dent Don­ald Trump this week signed a gov­ern­ment fund­ing ex­ten­sion that in­clud­ed a pro­vi­sion that cod­i­fies that process and runs counter to a 2021 ap­peals court de­ci­sion against the agency.

The al­ter­ation on or­phan ex­clu­siv­i­ty in the spend­ing pack­age, which the FDA had been lob­by­ing Con­gress to fix since at least 2022, means the agency can still ap­prove drugs for nar­row­er us­es or in­di­ca­tions even if a com­peti­tor has an ap­proved drug for the same dis­ease.

While the agency an­nounced that it would­n't change its or­phan des­ig­na­tion process in Jan­u­ary 2023, the move ran counter to what the US Court of Ap­peals for the Eleventh Cir­cuit told the FDA in 2021. The de­ci­sion said the agency shouldn’t have ap­proved two drugs for the same dis­ease when one had ex­clu­siv­i­ty, even if the two were geared to­ward dif­fer­ent pa­tient pop­u­la­tions.

Ge­off Mc­Do­nough is tip­ping his hat to one of the hottest tar­gets in drug de­vel­op­ment right now.

The for­mer Gen­er­a­tion Bio CEO has joined NodThera to get its NL­RP3 pro­gram in­to Phase 3 next year as a bevy of drug de­vel­op­ers shut­tle their prospects through the clin­ic. That in­cludes Lil­ly-ac­quired Ven­tyx Bio­sciences, BioAge Labs, re­cent pub­lic en­trant In­sil­i­co Med­i­cine, Neumo­ra and count­less oth­ers.

“I got re­al­ly in­trigued by the pow­er of the mech­a­nism, and it’s an or­thog­o­nal mech­a­nism to the oth­er things that we know are im­por­tant in those dis­eases: in­sulin con­trol, SGLT2s, GLP-1s, lipid-low­er­ing agents,” Mc­Do­nough said in an in­ter­view with End­points News on his fourth day on the job. He joined NodThera’s board in De­cem­ber and, as of Feb. 2, he’s al­so CEO. He suc­ceed­ed Daniel Swish­er, who left in Oc­to­ber af­ter an 18-month stint at the UK and US biotech.