John
Fritze
Published
8:25 AM ET Fri, 4 May 2018 USA Today
President Trump is
preparing to deliver a long-awaited address on prescription drug prices as soon
as next week, but advocates warn the White House may be focused more on populist
messaging than swallowing bitter pills.
Trump lamented the rising cost of drugs during his campaign and
last year he accused pharmaceutical companies of "getting away with
murder." He blasted other countries for controlling prices and vowed to
the cost of drugs in the U.S. "way down."
But based on more recent statements from the president as well
as remarks made by members of his administration — many of whom previously
worked for drug companies — few expect Trump to offer up major changes in the
address.
"We are not hopeful, but we'd love to be wrong," said
Peter Maybarduk, director of Public Citizen's Global Access to Medicines
Program. "The signals are pointing mostly in the wrong direction."
.@Merck
Pharma is a leader in higher & higher drug prices while at the same time
taking jobs out of the U.S. Bring jobs back & LOWER PRICES!
Studies
show the increase in drug prices are having a big impact on American
households. 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.
Health
and Human Services Secretary Alex Azar,
a former executive at drug maker Eli Lilly, said this week that Trump wants to
go "much further" on the issue, but offered few specifics. An
unpublished proposal on drug pricing recently submitted to the White House by
HHS was marked as having little economic impact, an indication the
administration is not contemplating fundamental changes.
The
White House had previously said Trump would use the speech to ask HHS for ideas
to address the problem. The speech was scheduled for April 26 but was delayed
when Azar was hospitalized with diverticulitis. A White House spokesman did not
respond to questions about the contents of the upcoming address, or its timing.
"I'm
not expecting significant changes," said Rachel Sachs, a Washington
University law professor who blogs about drug policies. "One of the things
to watch for in the speech is what the administration says it can do on its own
and what it needs Congress' help with."
Trump
has already put pressure on the drug industry in ways that even some critics
have applauded. The Food and Drug
Administration has sped up approval of generic drugs, injecting
more competition in the market. The president's proposed budget floated the
idea of giving some states leverage to negotiate prices in Medicaid.
And the
White House has proposed requiring pharmacy benefit managers, which act as
middlemen between drug companies and insurers, to pass along to Medicare beneficiaries the savings they
negotiate by buying large quantities of drugs. That idea wouldn't lower the
price of medicine, but it could reduce out-of-pocket costs for patients.
The
administration has also been scrutinizing lower prices paid in other countries,
a favorite issue for the president. White House economic advisers recommended
this year that the administration use "enhanced trade policy" to
pressure other nations against negotiating prices that are far lower than what
U.S. patients and insurers will pay.
Analysts
say many of those proposals could have an impact, but they will take time to
implement — and may affect a small number of patients.
"These
are all tweaks around the edges," Sachs said.
What
the president is unlikely to do is allow Medicare to negotiate drug prices.
Trump embraced that idea during the presidential campaign but has not pursued
it since taking office. Azar said this year that allowing negotiations would
limit the choice of drugs available to seniors.
Less
clear is whether the administration will step up enforcement of
anti-competitive practices. In the case of price gouging, for instance, federal
law allows the government to override patent protection in exchange for
compensation. The Bush administration came under pressure to consider that move
with the anti-anthrax treatment Cipro in 2001, but drug maker Bayer decided to
voluntarily reduce its price instead.
FDA
Commissioner Scott Gottlieb has
hinted that Trump's address will focus at least in part on those practices.
Gottlieb told a conference in Washington on Thursday that the administration
wants to "dismantle many of the provisions that shield parts of the drug
industry from more vigorous competition."
Trump's
rhetoric on drug prices has reflected public apprehension on the issue. Just more
than half of Americans believe passing legislation to address drug prices
should be a "top priority" for Washington, according to a Kaiser
Health Tracking Poll in March.
And the
added pressure from the White House has also intensified finger pointing within
the labyrinth of industries involved in prescriptions. Pharmaceutical companies
blame insurers and pharmacy benefit managers. Those groups counter that it is
the drug makers that decide how much to charge for their product.
"The
problem is the price," said Will Holley, a spokesman for the Campaign for
Sustainable Rx Pricing, which represents insurers and large PBMs such as CVS
Health. "At the end of the day there's one player that sets the price of
drugs."
Holly
Campbell, a spokeswoman for the trade group Pharmaceutical Research and
Manufacturers of America, said patients are struggling to afford medicine
"because insurers and PBMs have been shifting more of the costs to them
for years."
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