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Ways Trump's Drug Price Plan Could Lower Rx Costs
12 May 2018, 12:57 | Floyd Cook
Trump condemns middlemen in drug-pricing speech
Trump's plan calls on providers in the 340B drug discount program to report on how they use the savings. But most of the measures could take months or years to implement, and none would stop drugmakers from setting sky-high initial prices. But the costs of R&D actually don't explain the elevated price of USA drugs compared with the rest of the world.
Drugmakers generally can charge as much as the market will bear because the US government doesn't regulate medicine prices, unlike most other countries.
"Right now, we don't have a truly free market when it comes to drug pricing, and in too many cases, that's driving prices to unaffordable levels for some patients", Gottlieb said in a speech last week.
- Banning a pharmacist "gag rule", which prevents druggists from telling customers when they can save money by paying cash instead of using their insurance.
The budget also called for moving some physician-administered drugs, which include expensive drugs for cancer, rheumatoid arthritis or multiple sclerosis, into prescription drug plans. And it would require prescription drug plans for Medicare patients to pass on some of the discounts and rebates they receive from pharmaceutical companies.
It's an approach that avoids a direct confrontation with the powerful pharmaceutical lobby, but it could also underwhelm Americans seeking relief from escalating prescription costs. "We're not calling for Medicare negotiation in the way that Democrats have called for", one of the senior officials told reporters Thursday night.
Perhaps the most threatening idea under consideration is to give the private health insurers who run Medicare plans more negotiating power with drugmakers.
"Trump had a choice today: to seek disruptive fundamental reform or to embrace more incremental steps", wrote Terry Haines, a financial analyst, in an investment note.
Drug companies also make rebate payments to insurance companies that manage Medicare Part D drug plans, as a way to attract their business. "The elephant in the room is, are we going to have a system that directly controls prices like the European system does", asked Coleen Klasmeier, head of the food, drug and medical device regulatory practice at law firm Sidley Austin. But as president he has shied away from major reforms and staffed his administration with appointees who have deep ties to the industry.
Trump revealed the instruction during a Friday announcement unveiling the administration's overall strategy for lowering drug costs. "Health policy experts like this idea because it reduces the burden on patients with serious chronic illnesses and spreads the expense of needed medications across the entire insured population", The New York Times said. The president unveiled his blueprint, coined American Patients First, in a Rose Garden ceremony on Friday.
Some more substantive changes are contemplated by the blueprint, although the document didn't lay out any concrete steps for how to achieve them.
The blueprint echoes some of those initiatives and says curbing abuse of FDA's Risk Evaluation and Mitigation Strategy (REMS) programs will be a priority to help generic drugs come to market faster.
Azar, in his briefing, emphasized his desire to change the way pharmacy benefit managers operate - specifically a system where they negotiate rebates off high drug prices. Would the drug's price similarly fade into the background?
The plan, however, is expected to mostly spare the pharmaceutical industry he previously accused of "getting away with murder".
The Pharmaceutical Research and Manufacturers of America, or PhRMA, praised the move but expressed concern about other proposed changes to Medicare.
"I think the mood, just generally, across the health sector is 'watch and wait, ' " said Mark Merritt, president of the Pharmaceutical Care Management Association, the lobby for pharmacy benefit managers.
"It's hard to know why Germany or France or Australia would agree to something like that", said Professor Jack Hoadley of Georgetown University's Health Policy Institute.
Unfortunately, hiking drug prices in the rest of the world will have little effect on Americans' prescription costs, health policy experts say.
But Trump has since abandoned ideas to lower drug costs he supported during the campaign, including allowing the government's Medicare plan for older Americans to negotiate prices directly with drugmakers, and enabling United States consumers to import lower-cost medicines from other countries.
The drug industry's top lobbying arm, Pharmaceutical Research and Manufacturers of America, spent almost $26 million to sway federal decision makers previous year, according to records tallied by the nonprofit Center for Responsive Politics. The annual total was the group's highest since the 2009 congressional fight that led to President Barack Obama's Affordable Care Act.
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