As he campaigns in Congressional races, President Trump has ramped up his rhetoric and his plans to lower prescription costs, a position he took during his presidential campaign but has yet to deliver on in a big way. Now, he and the Health and Human Services Secretary for the first time are proposing using prices from other countries as a basis for determining costs for drugs in Medicare. However, this plan only relates to drugs under Medicare Part B given in doctors’ offices rather than the broader Part D drug program for medicine received at a pharmacy.
Trump is also proposing that drug companies be forced to advertise the cost of their drugs publicly. The pharmaceutical industry is pushing back saying listed prices are not paid by most consumers since rebates are given to insurance plans which then charge co-pays to customers to pay part of the costs. Another bill that has passed both houses ends the gag rule imposed by pharmacy benefits managers which forbids pharmacists from telling patients they can get lower prices at the pharmacy counter by paying cash and not using their insurance for some low cost drugs. This bill does not cover prices for generic drugs though.
Democrats have been pushing for years for Medicare to negotiate systemwide on the price of drugs. The Trump Administration and Republicans in Congress have rejected that approach as hurting pharmaceutical companies research and developments costs. Trump’s fixation on international trade deals has made drug prices a target because he sees the US footing the entire bill for development costs and not getting the cost break that other countries do through negotiated prices by their national health plans.
It is really unclear if Trump will work hard to push these new pricing and advertising plans beyond the election. He seems to be offering many different ideas like a new tax cut, this drug plan and others just to get attention for voters during the campaign. However, even if he doesn’t push his own plans, the pharmaceutical industry is worried that Trump will team up with Democrats if they take control of the House of Representatives and agree on a broad plan to lower prices related to other countries or allow negotiation on drug prices for Medicare.
I have said for a long time that the pharmaceutical industry only has itself to blame for this predicament as it has engaged in setting exorbitant prices for insurance plans and customers by charging whatever they can get away. Politicians have been literally paid off by huge campaign contributions and they have refused to intervene to protect the public. There are too many sweetheart deals and loopholes that allow higher profits to be shared by pharmacy benefits managers and drug companies. Some in Congress say that government should not interfere in the pricing of drugs but they forget that the government is one of the biggest payers of health care in the country and it already negotiates prices for the Veterans Administration and other programs.