Trump Opposes Drug Bill

[AntiTrump]

This week, the U.S. House of Representatives will vote on H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act of 2019. H.R. 3 is a bold step toward reducing the high prices of prescription drugs through Medicare negotiation. The legislation gives the secretary of health and human services the authority to directly negotiate with drug companies for up to 250 of the highest-priced drugs—and all insulin—each year. The new, lower prices would be available to consumers with all sources of coverage, both public and private. Despite H.R. 3’s potential to dramatically lower prices for patients who rely on these drugs, President Donald Trump is opposing the bill, breaking his campaign promise to deliver lower drug prices.


: 85 percent of Americans support this tactic to reduce prices for Medicare and private insurance. Yet despite the policy’s popularity, and President Trump’s campaign promise to “negotiate like crazy” to reduce drug prices, the current administration opposes H.R. 3—the only bill that includes drug price negotiation. It should come as no surprise that the Trump administration is backpedaling on its claimed commitment to reduce drug company profits; some of the administration’s key players on health policy built their careers at pharmaceutical corporations.

 

[Oddball]

How many *ahem* "poison pills" (pun intended) have been stuffed into this bill?

 

[Crepitus]

How many *ahem* "poison pills" (pun intended) have been stuffed into this bill?

You tell us Spunky, it's your accusation.

 

[Billy_Kinetta]

Considering House Democrats current and past behavior, there's little doubt it's a Trojan Horse gambit.

 

[depotoo]

The bad news:
These proposals suffer from glaring omissions and loopholes that must be corrected.

1. First and foremost, the proposal only requires action on a minimum of 25 Medicare medicines a year with a maximum of only 250. The top 25 drugs in terms of spending account for only 23% of Part D drug spending, meaning that 7,975 drugs accounting for 77% of Part D funding could go unchecked.
2. Second, the proposal has no impact on or oversight regarding initial launch prices which can be gamed by biopharmaceutical companies to soak American payers until the drug reaches the top 25 (or maybe 250 list). This generates a very long lag time before there would be any deterrent restraint affecting drug prices, and would likely trigger further price gouging earlier, in anticipation of the effects of HR 3.
3. The proposal covers brand-name medicines that lack price competition, defined as lacking just one generic or biosimilar competitor. However, the entry of two competitors rarely reduces prices significantly according to previous studies and it is only when there are six competitors that bloated originator prices are reduced by 75%. Thus, there will be many brand name medicines excluded from negotiations where true competition has not yet significantly dented prices.
4. Fourth, the Average International Market price ceiling will be based on average prices charged in six high-price, upper-income countries (Australia, Canada, France, Germany, Japan, and the United Kingdom) and will be set at 1.2 times the average. These are all countries that also face high launch prices from Big Pharma, though they have historically achieved somewhat better pricing through negotiation, price controls, and use of therapeutic formularies. But the average ceiling price will in no sense be justified by any economic or therapeutic benefit analysis. Similarly, the proposal does not explain why the U.S. should pay as much as a 20% premium over the average price paid by other rich countries. Drug companies can (and expectedly will) seek to impose higher prices in those six reference countries in order to maintain higher prices and profits in the U.S. Although the President has trumpeted his intention to make other countries pay more, there is no justification for this result given the bloated global profits that the biopharmaceutical industry earns year after year. At the very least, any resulting legislation should provide for studies of and aggressive remedies to correct these harms.
5. Fifth, although there is some limited R&D cost, manufacturing cost, and sales transparency for the government that this bill would trigger, such information would be kept from the public despite the public’s right to such information.

What is missing?
The real solution to correcting the stranglehold Big Pharma enjoys is to challenge their government-granted monopoly power and take away exclusive rights when they are so systematically abused. Given the pre-dominate role of public funding of R&D in break-through medical discoveries and the licensing of government owned drug discoveries, the U.S. should already be getting a much better deal both for government payers and the public-at-large. But, in many instances, the best solution to excessive drug pricing is to promote robust generic competition through lawful, government-imposed licenses, where multiple producers can make medicines efficiently and sell them cheaply while still making a profit and while still providing some remuneration to the patent holder.

We have to make sure that prioritized R&D is paid for, but it is a terrible system that requires (cont’d at link)
The “Lower Drug Costs Now Act of 2019”: What’s Good, What’s Bad, and What Must be Improved

 

[MisterBeale]

I think we know who to trust on this issue, eh?