After IRA, lawmakers look for more ways to cut drug prices

The passage of the Inflation Reduction Act (IRA) was a resounding victory for congressional Democrats over Big Pharma. But on Capitol Hill, it seems to have only whetted lawmakers' appetites for pharma pricing reform.

Tuesday, Democrats in the Senate doubled down, introducing legislation that would allow the Centers for Medicare & Medicaid Services (CMS) to negotiate prices of drugs much sooner than specified by the IRA.

The goal of the initiative—which is supported by 25 Senate Democrats and led by Amy Klobuchar (Minnesota) and Peter Welch (Vermont)—is for CMS negotiations to begin five years after drugs have been approved. The current standard, set by the IRA, is for biologic drugs to become eligible for pricing negotiations after 13 years and for small molecules after nine years.

And that’s not all. In a rare effort to build bipartisan support to lower drug prices, Sens. Bernie Sanders, I-Vermont, and Bill Cassidy, R-Louisiana, announced that the Health, Education, Labor and Pensions Committee will discuss four proposed bills at a hearing May 2.

Even after the IRA became law, Sanders continued his relentless battle to cut drug prices. Last month, he sent letters to leading diabetes manufacturers Novo Nordisk and Sanofi, urging them to reduce their prices for insulin after Eli Lilly did the same. Within two weeks, the companies followed suit.  

Industry association PhRMA did not respond immediately to a request for comment. The group has repeatedly criticized congressional efforts to limit drug prices, saying the industry's pricing freedom is essential to fueling innovation.

Sanders’ initiative this week surrounds four bills, including three that would increase access to lower-cost generic medicines. The most impactful bill would likely be the Pharmacy Benefit Manager Reform Act which would increase (PDF) the oversight of PBMs, which are often incentivized to limit access to generics.

All of the efforts come after lawmakers last year passed the IRA, which President Joe Biden signed in August. Aside from the CMS negotiations, the law allows CMS to penalize drugmakers for raising prices faster than the rate of inflation, among other measures.