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President Trump on Thursday tabled a plan to lower the price of some drugs Medicare pays, a move that could save taxpayers billions of dollars, but would also face resistance from the government. pharmaceutical industry.
This approach would test a plan to reduce the costs of certain drugs over five years by basing them on their costs in other countries. Before the mid-term elections on November 6, the government tried to refute the Democrats' claims that it did not do enough to fight the high price of drugs.
"This is a revolutionary change," said Trump, who highlighted the proposal in remarks to the Department of Health and Human Services. "Nobody had the courage to do it or just did not want to do it."
The proposal is likely to come into effect only at the end of 2019 or 2020 and would only cover certain Medicare drugs in some parts of the country. country. Some Democrats have said that this idea would do little in the short term and would not reach the promise of Mr. Trump's more aggressive campaign on the price of drugs.
Under the proposal, the Centers for Medicare and Medicaid Services would release a proposed rule this spring to change how it pays for injected and injected drugs administered by doctors in half of the country. The changes would only apply to certain drugs in the Medicare Outpatient Program called Part B, and not to the most commonly used drugs sold in pharmacies.
Medicare spent $ 28 billion on drugs used in Part B in 2016, up 59% from the remaining $ 17.6 billion. in 2011, CMS said in a statement. The agency said its planned experience would reduce drug spending by about 30 percent and save seniors money by reducing their coinsurance payments.
Compared to the United States, drug prices are significantly lower in many overseas countries. In Europe, governments control their costs directly or indirectly. In some cases, the national health service buys drugs and sets a price that manufacturers must meet to sell their products. US prices are set on the open market and after bargaining between insurers and hospitals
The proposal aims to encourage pharmaceutical companies to lower prices for some of Medicare's most expensive drugs. But he faces stiff opposition from the pharmaceutical industry, which said it was relying on US spending on drugs to fuel innovation and research.
"The adoption of foreign price controls on US innovation puts American patients as a last resort and decreases their hope of success. a better future, "said James C. Greenwood, general manager of the Biotechnology Innovation Organization, a group of the drug industry whose sales are based on Medicare Part B.
PhRMA, the professional group representing the major Pharmaceutical companies, said "Serious problems with Medicare Part B changes that threaten patients' access to life-saving drugs, undermine the quality of care provided by physicians or discourage Medicine. or focus on reducing inefficiencies in their operations to offset cost differences. Trump called other countries "independent", saying they reaped the benefits of US pharmaceutical innovation while paying much less.
The proposal provoked mixed reactions from legislators and consumer groups. Some considered it a public relations effort to rally support from voters to Republicans, who were looking for a winning message on health care before the mid-term.
The Trump Administration "concocted a show of dogs and ponies to deceive Americans think they are taking concrete steps to bring down drug prices – they are not," said the senator Ron Wyden (D., Ore).
Republicans, however, welcomed the proposal.
"Tennessees often struggle to afford prescription drugs, and this proposal seems to put patients and taxpayers first ", said Senator Lamar Alexander (R., Tennessee).
The US experience will last from 2020 to 2025 and will only apply to certain drugs manufactured by a single manufacturer and those known as organic products, made from living organisms.
As part of the proposal, the federal government would also consider having vendors negotiate prices rather than m doctors and hospitals and pay doctors administer medicatio ns instead of a percentage of the purchase price.
Under current policy, doctors' offices and hospitals buy outpatient drugs and then bill Medicare for reimbursement. The government remunerates physicians based on the average net prices reported by pharmaceutical companies for each drug, plus an additional 4.3% of the selling price. Critics have long argued that "extra" percentage-based charges create incentives for doctors to use more expensive drugs, a concern cited by CMS on Thursday.
CMS stated that it would test ways to replace the percentage-based payment with a lump-sum payment that would eliminate incentives to prescribe more expensive drugs without reducing overall payments to physicians.
– Thomas M. Burton contributed to this article.
Write to Stephanie Armor at the address [email protected] and Joseph Walker at the address [email protected]
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