Thursday, 19 July, 2018

President Trump aiming to lower prescription drug prices

Johnson & Johnson’s stock Drug Importation 'Just a Gimmick,' Says HHS Secretary
Johnnie Parks | 15 May, 2018, 00:59

President Donald Trump delivered his long-awaited drug pricing proposal on Friday. He blasted drug makers, health insurers, pharmacy benefit managers and others for profiting off American patients.

I sat down with Steve Ubl, CEO of the drug industry's main lobbying group, PhRMA, yesterday preceding Trump's speech.

The administration also released a 44-page blueprint of the plan, entitled American Patients First. Last year, the FDA approved more than 1000 low-priced drugs.

"There are over 50 actions that we have in the blueprint", Azar said, according to a transcript. The administration seeks "fundamental structural change" to a system of "entrenched market players", he commented in a press briefing.

Mr. Trump also wants to repeal Obamacare's cap on penalties drug companies must pay when they raise prices faster than inflation, though it will require legislation from Congress.

"Had he followed through on his campaign promise to negotiate lower Medicare drug prices and import safe drugs from Canada, shock waves would have reverberated through Big Pharma", Welch said. Trump said the goal of the plan was to reduce the cost of drugs, however, the few points he mentioned would not really help that goal. "It's unfair and it's ridiculous, and it's not going to happen any longer". The President also called for the U.S. trade representative to address this "injustice" in trade discussion with all trading partners.

Part B covers physician-administered drugs whereas Part D covers prescription drugs. Under this system, the government pays the full list price and doctors make more money when they prescribe more expensive drugs.

But the blueprint did not call for Medicare to negotiate lower prescription drug prices, an idea the Indian industry had feared all along.

Because Trump went easy on pharma, shares of drugmakers spiked after the speech.

"Everyone involved in the broken system - the drugmakers, insurance companies, distributors, pharmacy benefit managers, and many others - contribute to the problem", Trump said.

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During Trump's tenure, administration officials have provided some insights into how they intend to address the cost of prescription medicines.

In his remarks, Azar outlined a presidential directive to "bring negotiation where it doesn't exist", merging Part B, Medicare's program for physician-administered drugs, with Part D. The Part D program was implemented in 2006 - when Azar was deputy health secretary and before he departed to become president of Eli Lilly's US subsidiary.

Mr. Azar said the type direct negotiation that takes place in European countries would not work - and could be risky.

Health and Human Services Secretary Alex Azar, a former pharmaceutical company executive, said numerous actions the government was considering would not require approval by Congress and could take place through executive action within months. "I can tell you I wouldn't have wanted to be the one to do that", he said. More broadly, the president is calling for Part B to merge into Part D, Azar said.

The federal government now pays providers 6% more than the average price of those medicines. But we also need to be doing more. Azar queried. That, he said, would give consumers more balanced information, and companies would face "a very different set of incentives for setting their prices". The head of the drug cost reduction project, Daniel Best, is also an ex-Pfizer executive.

Currently, any medications a manufacturer includes in the federal Medicaid drug rebate program are automatically on the formulary.

Other initiatives taken by the FDA to streamline generic drug development include: prioritizing the review of certain generics; publishing a list of off-patent, off-exclusivity branded drugs; and enhancing the efficiency of certain aspects of the submission process for generic drug applicants.

While Trump has vowed to tackle rising prices since running for office, his plan spared the pharmaceutical industry from direct government negotiations to control costs. The new trade policies will work on making this price gap small.

Health policy experts, however, have questioned whether the administration's proposals to date will have a meaningful impact on the high cost of prescriptions.

"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.

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