Healio Special Report: Health Care and Politics
Healio Special Report: Health Care and Politics
May 11, 2018
4 min read

Trump unveils long-promised plan to lower drug prices

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President Donald J. Trump said the days of pharmaceutical companies, special interest groups and foreign governments controlling drug pricing are over, as he unveiled his set of proposals for lowering drug prices earlier today — his first public remarks devoted to the issue after often calling it a priority during the first 16 months of his administration. 

His plans call for reversing incentives on list prices, reducing regulatory burden, approving more generics and making sure drug development and financing programs are current to negotiate the best deals possible with drug companies, reducing patients’ out of pocket expenses, and ensuring adequate competition.

“[My] plan also gives Medicare Part D new tools to negotiate lower prices for more drugs, and makes sure that Medicare Part D incentives encourage drug companies to keep prices low,” he said. “We are not going to reward companies that constantly raise prices, which in the past has been most companies.”

Trump also called for removing what he called a “gag order” that keeps pharmacists from discussing cheaper medication options, but it was unclear what he was referring to.

He also said he would punish companies that exploit patent laws to remove competition, speeding up the approval process for over-the-counter medications and demanding fairness from countries importing drugs from US-based manufacturers.

“When foreign governments extort unreasonably low prices from U.S. drug makers, Americans have to pay more to subsidize the enormous cost of research and development … and that is unacceptable … and it’s not going to happen any longer. It’s time to end the global freeloading once and for all.”

The president was flanked by HHS Secretary Alex Azar II, who called the proposal “the most comprehensive action plan for drug affordability” in history and said it entails some 50 ideas.

President Donald J. Trump said the days of pharmaceutical companies, special interest groups and foreign governments controlling drug pricing are over, as he unveiled his set of proposals for lowering drug prices earlier today — his first public remarks devoted to the issue after often calling it a priority during the first 16 months of his administration.
Photo Source: Shutterstock

“It’s been a complicated process, but not too complicated, and today it is happening,” Trump said. “We will have tougher negotiation, more competition, and much lower pricing at the pharmacy counter and it will start to take effect very soon.”

Trump’s pledge to lower drug prices was one of the main themes of his presidential campaign, was reiterated during his State of the Union address earlier this year and was part of his 2019 budget proposal.

Immediately after the speech, just before 2:30PM ET, share prices of stocks in drug companies such as Valeant, AbbVie, Amgen and Pfizer were up but were varied in the hours and days leading up to the speech. These same companies’ stock prices’ dropped when he said he in a late 2016 interview that he would attempt to bring down drug prices after taking office.

Today’s Rose Garden announcement followed a week of administration officials laying the ground work for the president’s proposals.

A report in The Hill suggests that parts of the 2019 budget proposal would limit out-of-pocket spending for Medicare prescription drug program enrollees and, separately, allow five states to explore the option of drug coverage and financing in their respective Medicaid programs.

Additional proposals are coming, Trump said today, but those will require Congressional action. Reuters previously reported last week that Congressional action on the president’s proposals does not seem plausible.

The American Academy of Family Physicians told Healio Family Medicine it would review the specifics of the president’s proposal before commenting, but noted high cost of medications has long been a concern it has addressed with lawmakers and federal agencies.

Michael Munger
Michael Munger

“As an individual organization and as a member of the Campaign for Sustainable Rx Pricing, the AAFP has called for legislation that would the lower cost of prescription drugs. We support allowing Medicare to negotiate drug prices, increasing price transparency and speeding up the entry of generic drugs to the market. And we’ve called for dropping preauthorization requirements for generic drugs,” Michael Munger, MD, AAFP president, said in an interview. “The AAFP also has called on CMS to revise their requirements of Part D prescription drug plans and Medicare Advantage plans so patients have a broader choice of adequate and affordable prescription drugs.”

“These plans have attempted to control rising drug prices by changing their formularies and requiring prior authorizations before covering some prescriptions,” he continued. “The new formularies limit medications that are covered and the prior authorization requirements divert physician time from direct patient care. We’ve urged CMS to design less restrictive formularies that offer patients and physicians more choices to accommodate patient preferences and cost differences.”

David Barbe
David O. Barbe

AMA president David O. Barbe, MD, expressed optimism after hearing the speech.

“The AMA is pleased the Trump administration is moving forward with its effort to address seemingly arbitrary pricing for prescription drugs. Physicians see the impact of skyrocketing prices every day as patients are often unable to afford the most medically appropriate medications — even those that have effectively controlled their medical condition for years,” he said in a statement.

“No one can understand the logic behind the high and fluctuating prices. We hope the administration can bring some transparency and relief — to patients.”

ACP had no immediate comment, but issued a policy paper outlining seven recommendations during the waning months of President Barack Obama’s second term that that it felt would slow the rise of costs.

These ideas included complete transparency of pricing, cost and value of pharmaceutical products, ending restrictions on using quality-adjusted life-years in Patient-Centered Outcomes Research Institute research and allowing publicly funded health care programs like Medicare to negotiate volume discounts, reimporting drugs manufactured in the United States, and supporting programs that increase competition for sole-source drugs. – by Janel Miller