Welcome to the FiercePharma political roundup, where each Monday we’ll highlight developments in Washington, D.C., and elsewhere that could affect how drugmakers operate.
The drug pricing war of words between Republicans and Democrats continued last week as President Donald Trump tweeted that he and Department of Health and Human Services Secretary Alex Azar will soon release a drug importation plan. The president said the Democrats’ plan, released in September, “doesn’t do the trick” and delivers fewer new drugs. Pharma companies and others have opposed importation, saying it could threaten the U.S.' secure drug supply chain. Industry has also pushed back hard on House of Representatives Speaker Nancy Pelosi's ideas.
Importation isn't a new idea. Earlier in this yearslong drug pricing debate, Sen. Bernie Sanders and the late Rep. Elijah Cummings pushed the proposal back in 2017. Consideration about the measure goes back before their plan, at least to healthcare reform discussions in 2009.
...While we had the first prescription drug price decrease in 50 years, Americans still pay far too much for drugs – other countries pay far less – that is WRONG! We will soon be putting more options on the table...— Donald J. Trump (@realDonaldTrump) November 22, 2019
Alternatively, Pelosi’s plan calls for Medicare price negotiations, an international pricing index, potential fines for drugmakers and more. Trump originally said it’s “great to see” the proposal, but the White House backed away more recently and signaled more support for a bipartisan effort in the Senate. In the Senate, lawmakers are pushing to simplify Medicare Part D, an out-of-pocket cap for Part D patients, tweaks to Medicare Part B and more transparency for pharma middlemen.
Also last week, FDA commissioner nominee Stephen Hahn faced Senate questioning over his views and plans for the agency ahead of a potential confirmation. On drug pricing, the nominee followed in the steps of former commissioner Scott Gottlieb, Cowen analysts wrote in a note to clients. Hahn said the FDA can have an “indirect” role in drug pricing by stimulating competition. The nominee also “avoided every invitation to criticize the drug industry directly,” the analysts wrote.
In a new pricing twist, the American Medical Association supported an “arbitration” process to drive drug costs down. The process would be managed by independent, informed mediators who would choose bids by either pharma companies or payers in areas of high drug prices and limited competition. The status quo "allows unilateral price setting of drugs by manufacturers without regard to patient access and affordability," according to an AMA report. An arbitration process would provide "incentive for drug manufacturers and payers to arrive at a negotiated price.”