Drug prices: Trump unveils controversial new rule in ultimate attempt to keep campaign promise

by



[ad_1]

If the two measures announced on Friday survive legal challenges, they will radically transform the national drug price system. One of them will charge Medicare the same price for certain expensive prescription drugs as other developed countries, a “most-favored-nation price.”

The other will effectively ban drugmakers from giving discounts to drug benefit managers and insurers – a dramatic change in the way many drugs are priced and paid for in Medicare and Medicaid. Instead, drug companies will be encouraged to pass discounts directly to patients at the pharmacy counter.

During a 22-minute press conference, Trump went through a long list of drug pricing efforts his administration has undertaken during his four years in office. Many, however, remain at the proposal stage, have been stopped by the courts, or have had little impact. Prices continued to rise, although the pace slowed under his presidency.

He also alluded to the fact that he might not be in office next year. “I just hope they keep it. I hope they have the courage to keep going because the powerful drug lobby Big Pharma is pressuring people like you wouldn’t believe,” Trump said. , referring to one of the rules.

The new rules come just days after Pfizer and Moderna announced the results of their coronavirus vaccine trials. The president accused companies earlier on Friday of withholding the news until the end of the election in retaliation for his efforts to cut drug prices.

Base Medicare reimbursement on drug prices in other countries

The rules stem from a series of executive orders that Trump issued in July and September.

Most-favored-nation rule allows the United States to take advantage of discounts negotiated by other countries – since Congress banned Medicare from negotiating with drug makers. Other countries typically pay much less for drugs, in large part because their governments often determine the cost – which flies in the face of Republicans’ allegiance to the free market system.

Although Trump criticized the socialist health care systems that exist in other countries and attacked his Democratic rivals for seeking to implement such a setup here, he celebrated the link between U.S. prices and lower costs of peer countries.

“In short, with this rule, the leader of the Republican Party endorses the proposition that Americans should not pay higher prices than citizens of other countries – and he is ready to endorse the adoption of European price controls to reduce prices here “, tweeted Rachel Sachs, associate professor of law at the University of Washington.

The model, which will run for seven years, will test the most-favored-nation price payment for 50 Medicare Part B drugs administered in doctors’ offices. These drugs represent about 73% of part B drug spending. This will replace the current system, which pays the average selling price plus a 6% mark-up.

The rule, which takes effect in early 2021, could save patients $ 28 billion.

The President’s Executive Order in July broadened the initiative to include some Part D drugs sold in pharmacies, but Friday’s rule only referred to Part B drugs. The Part D version is in the works. development, said Seema Verma, administrator of the Centers for Medicare and Medicaid Services.

Trump first introduced an international price index proposal to set Medicare reimbursement levels for certain drugs on their cost in other countries in October 2018, seeking to bolster Republicans’ stance on health care the days preceding the midterm elections. He called for the “target price” to be 126% of the average of what other countries pay.

Drive discounts to consumers

The second rule will effectively prohibit drug manufacturers from giving discounts to drug benefit managers and insurers – a dramatic change in the way many drugs are priced and paid for in Medicare and Medicaid. Instead, drug companies will be encouraged to pass discounts directly to patients at the pharmacy counter.

On Friday, HHS said patients could possibly save almost 30%. This will affect patients whose out-of-pocket expenses are tied to the list price of a drug – for example, those who must meet a deductible, use a drug not covered by their insurance, or pay a list price co-pay. . Those with high drug costs will benefit the most.

However, the Trump administration backed down from publishing the rule last year after finding it increased costs for seniors and the federal government.
The proposed rule was to increase Medicare premiums, while saving money only for the 30% of Medicare Part D registrants who spend a lot on drugs, according to the administration’s 2019 estimates. It would also have cost the government. federal $ 177 billion over 10 years, according to the Congressional Budget Office.
Trump’s July executive order called for this rule to be put in place, but only if it didn’t increase costs. Health and Human Services Secretary Alex Azar said on Friday there was a wide range of actuarial estimates, some of which showed the rule would produce savings. He does not think the measure will increase premiums based on rebate and premium trends over the past 15 years.

Experts disputed this claim.

“Despite an actual analysis of the effect of this rule on spending and bonuses showing HUGE increases, Azar says it won’t matter because he knows it,” tweeted Stacie Dusetzina, Associate Professor of Health Policy at Vanderbilt University Medical Center.

It will come into force at the beginning of 2022.

Immediate opposition from industry

Pharmaceutical industry groups immediately criticized the rules, promising to consider all options to stop the measures.

PhRMA, the lobbying group for drugmakers, said the most-favored-nation rule would threaten medical innovation in the United States and hurt patients.

“It flies in the face of logic that the administration blindly pursues a ‘most favored nation’ policy that gives foreign governments the upper hand in deciding the value of drugs in the United States,” said Stephen J Ubl, CEO of PhRMA. “History shows that when governments take unilateral action to set prices, it disrupts patients’ access to treatment, discourages investment in new drugs, and threatens jobs and economic growth.

Industry organizations representing insurers and pharmacy benefit managers have criticized the reimbursement rule.

“Simply put, the [Health and Human Services] The secretary’s decision to advance the previously withdrawn discount rule will dramatically increase premiums for Medicare Part D beneficiaries and costs to taxpayers, ”said JC Scott, CEO of the Pharmaceutical Care Management Association, which represents benefit managers. pharmaceuticals. ” PCMA will explore all possible litigation options to stop the rule from taking effect and destabilizing the Medicare Part D program that millions of beneficiaries rely on. “

The Democratic House leaders, who have presented their own plan to cut drug prices, have attacked Trump.

“ As the coronavirus rises across the country, President Trump is spending his twilight days in office pushing through half-baked proposals that will likely be thrown out in court because he desperately seeks to cover up the failure of his administration to actually reduce drug prices, ” said Energy and Commerce Committee Chairman Frank Pallone, Jr. of New Jersey, and Ways and Means Committee Chairman Richard E. Neal of Massachusetts.



[ad_2]

Source link