Trump assails high drug prices but avoids action

13 May, 2018, 01:03 | Author: Brooke Harris
  • President Donald Trump speaks during a roundtable discussion on tax reform at the Cleveland Public Auditorium in Cleveland Ohio U.S. May

But the announcement also represented a shift and arguably a reversal for Mr. Trump, who as a candidate and newly elected president said he would embrace more far-reaching ideas, such as allowing the importation of lower-cost prescription drugs and letting Medicare negotiate directly with drugmakers.

The federal government now pays providers 6% more than the average price of those medicines.

Just last month, the U.S. in its annual report card on the protection of intellectual property rights around the world had criticised the drug pricing and reimbursement policies of India and several other countries like Canada, South Korea, Japan, New Zealand and a number of European nations, saying that they did not adequately recognise the value of innovative medicines.

Allowing Medicare to negotiate prices is unacceptable to the powerful drug lobby, which has spent tens of millions of dollars since Trump's inauguration to influence the Washington conversation around drug prices, including a high-profile TV advertising campaign portraying its scientists as medical trailblazers. "It's unfair and it's ridiculous, and it's not going to happen any longer", Trump asserted. "We are not going to reward companies that constantly raise prices, which in the past has been most companies".

Azar said in a speech Wednesday that other countries are "free-riding off of American investment in innovation", a reference to the United States' paying much more for drugs than many other developed countries.

The Pharmaceutical Research and Manufacturers of America, or PhRMA, praised the move but expressed concern about other proposed changes to Medicare.

Some of the administration's longer-term priorities include restricting use of rebates, creating incentives for drugmakers to lower list prices and investigating tools to address foreign government practices that it said could be harming innovation and driving up U.S. prices. The president unveiled his blueprint, coined American Patients First, in a Rose Garden ceremony on Friday. The industry has touted the slower growth as it weathers public backlash. He said he would make it easier for pharmacists to inform patients of cheaper alternatives and would speed the approval of over-the-counter drugs "so that patients can get more medicines without prescription".

Look into reducing or eliminating the drug supply chain's reliance on rebates pharmacy-benefit managers negotiate in secret with drug companies.

Trump officials have hinted for weeks that the plan, in part, will untangle the convoluted system of discounts and rebates between drugmakers and insurers, pharmacy benefit managers and other health care middlemen.

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"It's not everything I'd hoped for", Dr. Bach said in an interview, but "this is a sign the administration wants to work on a number of fronts, and I'm encouraged by that".

Since Trump took office, most of the action on drug pricing has come from the Food and Drug Administration, which has gone about as far as it legally can on the issue by pushing for greater competition in drug markets. Drug prices vary widely based on a consumer's insurance plan.

"A lot of what they focus in on is not really the price of pharmaceuticals, as much as the out-of-pocket payments of the patients at the pharmacy", said Craig Garthwaite, an associate professor of strategy at Northwestern University's Kellogg School of Management. Pharmaceutical stocks dipped slightly during the president's speech before rising again. Presciption rices have not been lowered at all.

Requiring Part D plans to pass on rebates to consumers is one idea PBMs have rallied against.

The president also blasted foreign governments, alleging they force drug companies to sell at low prices in their countries, driving up costs for American consumers.

Azar said he would meet with the White House next week to begin implementing the proposals, which will take months to go through the rulemaking process.

Democrats called Trump's promises hollow, pointing to December's tax law that slashed the corporate tax rate for drug manufacturers, insurers and pharmacy benefit managers.

But he dropped the popular proposals of his campaign, opting not to have the federal government directly negotiate lower drug prices for Medicare. "Why? Because of the drug companies". An AARP report last year found the average annual price of drugs widely prescribed to seniors increased to $12,951 from $6,425 five years ago. Democrats blame high health costs on GOP efforts to dismantle the Affordable Care Act without a plan to replace it, while Republicans continue to fault the law itself, also called Obamacare. But the president has offered nothing but "radio silence" since then, Cummings said Thursday.

Neither of those proposals was mentioned in Friday's speech. Specifically, the blueprint calls for HHS to leverage the Competitive Acquisition Program for Part B. The plan would seek to improve negotiation within the Medicare program, but not by using the government's clout to negotiate for Medicare as Trump has previously proposed.



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