Free Daily Headlines :

  • COVID-19
  • Vaccine Info
  • Money
  • Politics
  • Education
  • Health
  • Justice
  • More
    • Environment
    • Economic Development
    • Gaming
    • Investigations
    • Social Services
    • TRANSPORTATION
  • Opinion
    • CT Viewpoints
    • CT Artpoints
DONATE
Reflecting Connecticut’s Reality.
    COVID-19
    Vaccine Info
    Money
    Politics
    Education
    Health
    Justice
    More
    Environment
    Economic Development
    Gaming
    Investigations
    Social Services
    TRANSPORTATION
    Opinion
    CT Viewpoints
    CT Artpoints

LET�S GET SOCIAL

Show your love for great stories and out standing journalism

The long road to lower drug prices hits some potholes

  • Health
  • by Emmarie Huetteman | Kaiser Health News
  • July 28, 2019
  • View as "Clean Read" "Exit Clean Read"

When Washington returned from its winter holiday break in January, it seemed everyone was talking about lowering drug prices.

Energized by a new class of freshmen and a few weeks away from the office, members of Congress were ready to wag their fingers at drug company executives and pitch their fixes. President Donald Trump had unveiled some of his solutions to a problem he said was a top priority, and more would follow.

Now it’s July, and whether it’s the humidity or the lobbyists, Washington — and the prospects for substantial change — look hazy. Two of the Trump administration’s primary targets, slashing rebates to drug supply middlemen and requiring prices in drug ads, fell apart in recent weeks.

But others live on. Let’s walk through some of the most significant proposals to reduce pharmaceutical costs — and see where they ended up.

Capping price hikes under Medicare? A tough sell.

On Tuesday, Sen. Chuck Grassley (R-Iowa), chairman of the Senate Finance Committee, and the committee’s top Democrat, Sen. Ron Wyden of Oregon, released the details of a sweeping plan to control drug costs under Medicare and Medicaid.

One of the most significant proposals in the plan would cap price increases on brand-name drugs and biologic drugs covered by Medicare to ensure they do not outpace inflation, and triggering rebates when they do.

The proposal would start by comparing prices to an “anchor” price set on July 1, 2019 (or, for new drugs, the date they were first marketed), and adjusted for inflation, according to Grassley’s office.

Gage Skidmore

Sen. Chuck Grassley

Under Medicare Part B, the prices would be based on a drug’s average sales price; under Part D, the prices would be based on a drug’s list price.

If a drugmaker increases the price of its drug more than the rise in inflation, it would owe Medicare the difference between the prices as a rebate.

Proponents say that change could shield more Americans from the kinds of eye-popping price hikes that have sparked a public outcry in recent years. But Republicans are likely to oppose the idea, which they claim amounts to government price controls.

Medicaid already applies this strategy and tends to pay better prices on drugs. A report from the HHS inspector general found that Medicare could have collected as much as $2.4 billion in rebates on just 20 brand-name drugs covered by Part B in 2010 had drugmakers been required to pay the same rebates they pay Medicaid.

Dr. Aaron Kesselheim, a professor of medicine at Harvard Medical School who researches the effects of intellectual property laws on drug development, pointed to the problematic lack of restrictions dictating how drugmakers set prices.

“I think that’s a very promising idea, if it sees the light of day,” he said in an interview before the bill was unveiled.

The Senate Finance Committee will mark up the bill Thursday.

Buying your drugs from Canada? Bipartisan, and Trumpian, support.

Importing prescription drugs, an idea that has waxed and waned over the years, has received backing in this Congress, as well as the White House. Grassley, with Sen. Amy Klobuchar (D-Minn.), one of the seven Democratic senators running for president, introduced legislation in January that would allow Americans to import cheaper pharmaceuticals from Canada for personal use.

Trump has encouraged Florida Gov. Ron DeSantis in his effort to start an importation program there.

But perhaps the most intriguing development came July 11, when Health and Human Services Secretary Alex Azar — a former pharmaceutical company executive who had opposed drug importation — suggested an administration plan could be in the works.

Alex Azar

“My thinking has always been, if we’re going to have importation, we have to ensure the safety of the drug supply in the United States,” Azar told reporters, adding he believes things have “changed quite substantially” since the idea was discussed during George W. Bush’s presidency.

Azar served as a deputy secretary of Health and Human Services under Bush.

Those changes, particularly in international distribution, “could open the door to safe approaches,” Azar said. “And so the president and I are committed to importation and making that work, and we’re working on that now.”

Tying prices here to prices abroad? Stay tuned.

Earlier this month, Trump said the administration was working on a “favored nations” policy in which drug prices would be capped at the lowest price paid in another country.

The Office of Management and Budget is already reviewing an administration proposal for an “international pricing index” pilot project, through which Medicare would base the prices it pays for certain drugs on prices in other industrialized countries.

The issue dovetails neatly with Trump’s “America First” ideology, with the president railing against the idea that other countries’ citizens pay less than Americans for the same drugs. He announced the proposal last October, shortly before the midterm elections.

It also runs afoul of the traditional conservatives’ devotion to the free market, though. Grassley said in June that he opposes the pilot project, which he suggested could stifle innovation.

But with Americans paying so much more than other countries for brand-name drugs, something’s got to give, said Dr. Gerard Anderson, a health policy professor at Johns Hopkins University in Baltimore. “That’s just not long-term sustainable,” he said.

Rebate rule? We hardly knew ye.

For months, pharmacy benefit managers (PBMs), the middlemen who negotiate drug prices for insurers, were the target of bipartisan bashing. But this month, Washington abruptly backed off, as the Trump administration withdrew its proposal to eliminate some rebates collected by PBMs in their work for government health plans, including Medicare’s Part D drug benefit.

In January, HHS proposed passing those rebates along to Medicare and Medicaid beneficiaries as discounts at the pharmacy counter. PBMs would receive a fixed fee for their services.

It had “the potential to be the most significant change to how Americans’ drugs are priced at the pharmacy counter, ever,” Azar said then, explaining it would get rid of a practice that was driving up drug prices, especially for seniors.

The secretary punted the rebate issue to lawmakers, who “have more tools than we do.” The initiative would be expensive, and Medicare beneficiaries would likely feel some of the burden. He said: “We’re not going to put seniors at risk of their premiums going up.”

But Congress shows no interest in picking up the ball. In May, the Congressional Budget Office estimated the HHS proposal would cost the government an additional $177 billion over 10 years.

Now perhaps the biggest threat to PBMs lies in a sprawling package from the leaders of the Senate Health, Education, Labor and Pensions Committee. The bill from Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) would ban “spread pricing” — a PBM practice of charging health plans more than they reimburse pharmacies for drugs, allowing them to collect the difference as profit.

Help for generic drugmakers? There’s still hope.

When it comes to lowering prices, this is one of the few arguments echoed by progressives and conservatives alike: Brand-name drugmakers are suppressing competition in downright unsavory ways.

The Alexander-Murray plan includes a slew of proposals that would make it harder for those manufacturers to block generic competitors and maintain a virtual monopoly. A CBO estimate released Tuesday concluded the package’s proposals to reduce drug prices would save the government about $3.8 billion, and increase federal revenue by about $700 million over 10 years.

Their package includes the CREATES Act, a bipartisan bill aimed at curbing anti-competitive practices against generic drugmakers. Among other changes, it would make it easier for generic drug manufacturers to obtain samples of brand-name drugs to use in their research, thus helping to get their versions on the market faster.

Kesselheim of Harvard Medical School said he thinks the myriad proposals on generics are generally good ideas to help lower prices.

“They’re each like small, individual arrows,” he said. “And taken as a whole, I think they may be useful. But we’ll just see how many of them actually come to pass.”

Art of the drug deal? We’ll see.

Speaker Nancy Pelosi and other House Democratic leaders spent last month listening to their members’ ideas (and complaints) about the ambitious plans to lower drug prices. But they are still quietly working on a plan that would allow the secretary of Health and Human Services to negotiate prices on some of the most expensive drugs — and on behalf of all Americans, not just those with government health coverage, such as Medicare.

Putting aside progressives’ concerns that it doesn’t go far enough, the proposal faces stiff opposition among Senate Republicans, who say they worry about its impact on Medicare.

Skeptics include Grassley, whose views as head of the Senate Finance Committee could make or break any drug pricing proposal that finds its way to the Senate.

Still, House Democratic leaders have been in conversations with White House officials for a while about the plan’s broad strokes, according to a Democratic aide, raising the far-fetched prospect of an alliance between Pelosi and Trump.

Drug prices in ads? Preempted.

An eleventh-hour ruling from a federal judge this month blocked one of the Trump administration’s most prominent efforts to lower drug costs: a rule requiring drugmakers advertising any drug that costs more than $35 a month to include its list price in commercials. Administration officials hoped the requirement would shame the manufacturers into lowering costs.

But three companies — Merck, Amgen and Azar’s former employer, Eli Lilly — sued in June to stop the rule, claiming it violated their First Amendment rights and was not within the government’s authority to require them to disclose list prices. The judge agreed with the latter argument.

Anderson, the Johns Hopkins professor, was one of the researchers on a recent experiment that showed participants were less likely to seek out an expensive drug when its price was disclosed.

“I think that one would have made a difference,” Anderson said in an interview.

This story was first published July 24, 2019, in Kaiser Health News (KHN), a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

Sign up for CT Mirror's free daily news summary.

Free to Read. Not Free to Produce.

The Connecticut Mirror is a nonprofit newsroom. 90% of our revenue comes from people like you. If you value our reporting please consider making a donation. You'll enjoy reading CT Mirror even more knowing you helped make it happen.

YES, I'LL DONATE TODAY

ABOUT THE AUTHOR

Emmarie Huetteman | Kaiser Health News

SEE WHAT READERS SAID

RELATED STORIES
Medical providers are taking nature therapy seriously
by Jenifer Frank | C-HIT.ORG

In a time of social isolation and staying home, sometimes a walk in the park is the best medicine.

Have a case of a COVID variant? No one is going to tell you
by Christina Jewett and JoNel Aleccia | Kaiser Health News and Rachana Pradhan

Federal rules around who can be told about the variant cases are confusing, and tests have not been approved.

CT teachers are expected to get vaccinated for COVID at local clinics, but other options could cause problems
by Dave Altimari

School employees could end up on two lists, which means some vaccine might go to waste, officials said.

Grocery store workers ‘disgusted’ with Lamont’s new COVID-19 vaccine policy
by Keith M. Phaneuf

Grocery store workers are frustrated with Gov. Ned Lamont, who is no longer prioritizing them in the coronavirus vaccination schedule.

Breaking with national recommendations, Lamont says Connecticut’s vaccine rollout will now be prioritized by age
by Jenna Carlesso and Keith M. Phaneuf

People aged 55 to 64 will be next in line for the vaccine.

Support Our Work

Show your love for great stories and outstanding journalism.

$
Select One
  • Monthly
  • Yearly
  • Once
Artpoint painter
CT ViewpointsCT Artpoints
Opinion Lamont’s new vaccination priorities are simple and smart
by Richard Davies

Connecticut Gov. Ned Lamont’s new age-eligibility vaccine plan is simple, smart and straightforward. The more complicated the rules are, the greater the chance of screw-ups and of well-connected people getting their shots before they should. The governor is doing a good job.

Opinion Gas pipeline will threaten water quality, wildlife and wetlands
by Susan Eastwood

The Connecticut Department of Energy and Environmental Protection has granted tentative approval of the 401 water quality certification for the Pomfret to Killingly natural gas pipeline. I urge DEEP to deny the 401 certification, as the proposed pipeline would violate the Connecticut’s water quality standards, and the conditions in the draft certification fail to protect our streams, wetlands, and wildlife.

Opinion Connecticut and the other Connecticut. Which will endure?
by Ezra Kaprov

What comes to mind when you hear the word ‘Connecticut’? Possibly, you think of a 43-year-old Puerto Rican man who arrived here with his family following Hurricane Maria. He works full-time as a machinist at the Sikorsky plant, and he coaches a prizefighter on the side.

Opinion COVID-19 increases urgency for legislature to pass medical aid-in-dying law
by Dr. Gary Blick

The COVID-19 crisis has exposed the profound tragedy of loved ones dying alone, in a hospital or nursing home, without the care and comfort of loved ones surrounding them. This pandemic also demonstrates the fragility of life, the limits of modern medicine to relieve suffering, and has magnified the systemic racial disparities in our healthcare system, resulting in higher hospitalization and death rates for people in communities of color. We must eradicate these disparities, so everyone has equal access to the full range of end-of-life care options.

Artwork Grand guidance
by Anne:Gogh

In a world of systemic oppression aimed towards those of darker skintones – representation matters. We are more than our equity elusive environments, more than numbers in a prison and much more than victims of societal dispositions. This piece depicts a melanated young man draped in a cape ascending high above multiple forms of oppression. […]

Artwork Shea
by Anthony Valentine

Shea is a story about race and social inequalities that plague America. It is a narrative that prompts the question, “Do you know what it’s like to wake up in new skin?”

Artwork The Declaration of Human Rights
by Andres Chaparro

Through my artwork I strive to create an example of ideas that reflect my desire to raise social consciousness, and cultural awareness. Jazz music is the catalyst to all my work, and plays a major influence in each piece of work.”

Artwork ‘A thing of beauty. Destroy it forever’
by Richard DiCarlo | Derby

During times like these it’s often fun to revisit something familiar and approach things with a different slant. I have been taking some Pop culture and Art masterpieces and applying the vintage 1960’s and 70’s classic figures (Fisher Price, little people) to the make an amusing pieces. Here is my homage to Fisher -Price, Yellow […]

Twitter Feed
A Twitter List by CTMirror

Engage

  • Reflections Tickets & Sponsorships
  • Events
  • Donate
  • Newsletter Sign-Up
  • Submit to Viewpoints
  • Submit to ArtPoints
  • Economic Indicator Dashboard
  • Speaking Engagements
  • Commenting Guidelines
  • Legal Notices
  • Contact Us

About

  • About CT Mirror
  • Announcements
  • Board
  • Staff
  • Sponsors and Funders
  • Donors
  • Friends of CT Mirror
  • History
  • Financial
  • Policies
  • Strategic Plan

Opportunity

  • Advertising and Sponsorship
  • Speaking Engagements
  • Use of Photography
  • Work for Us

Go Deeper

  • Steady Habits Podcast
  • Economic Indicator Dashboard
  • Five Things

The Connecticut News Project, Inc. 1049 Asylum Avenue, Hartford, CT 06105. Phone: 860-218-6380

© Copyright 2021, The Connecticut News Project. All Rights Reserved. Website by Web Publisher PRO