How would a “competitive bidding process” for drugs work? We may soon find out, if President Donald Trump gets his way with the Republican healthcare bill.
Trump assured supporters at a Monday rally that drug prices are still a top priority for him—and to back that up, said he's working quickly to get a drug-bidding measure into the current repeal-and-replace bill.
If that doesn’t work, “we are going to have it right after,” Trump promised the crowd in Louisville, Kentucky.
Pushing for more competition in pharma isn’t an unfamiliar refrain from the president, who highlighted his desire for bidding during an infamous pre-inauguration press conference. At that appearance, Trump famously said pharma is “getting away with murder.”
Monday, he followed up with more sound bites. U.S. drug costs are “outrageous, many times higher than in some countries in Europe and elsewhere,” he said.
“Somebody is getting very rich,” he continued. “We are going to bring it down, we are going to have a great competitive bidding process.”
Trump has occasionally softened his tone since the January press conference, but he continues to maintain that drug prices are way too high. And he often leaves industry watchers clamoring for details about proposals to bolster competition—competitive bidding included.
Speaking in January about then President-elect Trump’s calls for a bidding system, Pfizer CEO Ian Read said Trump likely “hasn’t been briefed” on competition in the drug space. Pharma is “a very complicated industry," one with a “huge amount of bidding and extremely aggressive purchasing,” Read said at the time.
Earlier this month, after Republicans unveiled a healthcare bill that was free of any measures to address drug prices, Trump tweeted that a “new system” is in the works. Reacting to those statements, Evercore ISI analyst Umer Raffat wondered what Trump meant by bolstering competition.
Raffat wrote that brand vs. generic competition exists and direct brand vs. brand competition—particularly with competitive bidding—requires interchangeable meds, which isn’t always possible. On Friday, Trump selected Scott Gottlieb to lead the FDA, who could move to boost competition by enacting changes at the agency to speed new products to market.
It remains to be seen what kind of proposals might emerge, but Trump himself favors Medicare price negotiations, according to a spokesperson. Pharma critic Rep. Elijah Cummings met with the president earlier this month to discuss his proposal on the subject, and reported afterward that Trump was “enthusiastic” about the idea.