Trump Chief of Health asks Congress to adopt a drug reduction plan

Washington • The highest Trump administration health official on Friday asked Congress to adopt his new prescription drug reduction plan and offer it to all patients, and not just those covered by government programs such as Medicare.

Now hidden discounts between industry players, such as pharmaceutical companies and insurers, and transport them directly to consumers when they pay for their medications.

Patients whose copays are well protected will benefit from the proposal, while those who do not take prescription drugs, or who rely mainly on generics, would probably pay a little more because premiums are expected to increase.

One day after unveiling the plan as a settlement proposal, Health and Social Services Secretary Alex Azar raised the issues by calling on Congress to ensure he expanded the text to include people covered by the employer's health insurance, not just the Medicare and Medicaid beneficiaries.

"Congress has the opportunity to respond to its decision on their calls for transparency … by immediately adopting a bill and extending it to the drug market," Azar said in a statement. speech delivered in front of the think tank Bipartisan Policy Center.

Prior to next week's State of the Union address, President Donald Trump faces political pressure to achieve concrete results as part of his promise to reduce prescription drug costs . The data shows that prices of the original drugs have continued to increase, but at a slightly slower pace. Polls show consumers from all walks of life want government to act

Democrats say administration plan does not go far enough, as it still leaves pharmaceutical companies free to set government prices high catalog. They say that the price of drugs is like a black box and that it is impossible to say whether prices reflect actual costs or whether companies charge what the market will bear.

House Speaker Nancy Pelosi of D-Calif is also concerned. that the plan would increase premiums. HHS recognizes that Medicare prescription premiums would increase by $ 3 to $ 5 a month.

Nevertheless, the administration's proposal seems to be making its way as Congress prepares to legislate on the cost of prescription drugs. On Friday night, the Republican Chairman of the Senate Committee on Health, Education, Labor and Pensions expressed his support. The rebates "should reduce the costs borne by patients, and this is a good first step towards that goal," said Senator Lamar Alexander, R-Tenn., In a statement.

The complex plan would work by removing an exemption. [traduction]

Pharmaceutical companies pay discounts to ensure that their medications are covered by insurance plans that serve as intermediaries between them and their patients. According to HHS, hidden discounts can account for up to 30% of the current price of a drug. Insurers say they use money rebates to maintain premiums paid to all consumers.

Under this plan, the current rebate exemption for corporate rebates would be replaced by a new one for rebates offered directly to consumers.

Azar said the idea would reshape the drug pricing system from hidden discounts to immediate discounts, creating pressure on drug manufacturers to keep prices down. The proposal was co-written with the Office of the Inspector General of HHS.

Experts believe that it will take time to determine all the potential consequences.

Peter Bach, Director of the Center for Policy and Health Outcomes at Memorial Sloan in New York Kettering Cancer Center, said the current discount system is hurting patients who take expensive drugs with copays rates high.

Think of people with cancer, patients with intractable diseases such as multiple sclerosis or rheumatoid arthritis, generic competition. The cost sharing of patients is often based on current prices, not on the cost of the drug after discounts.

"In simple terms, those who do not take any medicine will see their premiums go up and will not save because they will not take any medicine," Bach said. "Those who only deal with generics can also belong to this category."

"But those who take expensive drugs … they will see total savings," he added.More than a half -million people have invested at least US $ 50,000 prescriptions in 2014, according to a report from Express Scripts.

Insurers and managers of pharmaceutical benefits such as Express Scripts and CVS They oppose the plan of administration, saying it would reduce their ability to negotiate with drug manufacturers at lower prices.

Consumers worry about the prices of prescription drugs. origin, especially promising new drugs, which generate nearly 90% of the prescriptions dispensed, while the original drugs account for more than 70% of the expenditures.

Azar argues that, under the current system, all world except the patient at a high price: a high list price gives way to larger negotiated discounts for insurers and intermediaries. Then, the drug manufacturers are content to incorporate this expectation into their prices

Before joining the Trump administration, Azar was one of the top leaders of drug maker Eli Lilly. This has led to criticism that he would be a pawn of the industry. However, drug manufacturers strongly disagree with some of his ideas, including an experiment using lower international prices to reduce Medicare costs.