Trump to unveil international pricing index, rebate crackdown rules: reports

Several years after saying the pharmaceutical industry was “getting away with murder,” President Donald Trump appears poised to unveil new drug pricing rules that could shake up U.S. pricing dynamics in a big way. But it remains to be seen exactly how the implementation will play out or whether the incoming Biden administration will keep the rules.

Trump plans to unveil two major measures—an international pricing index and a rule to crack down on drug rebates—on Friday, according to reports in The Wall Street Journal and Reuters. After campaigning on the issue of lowering drug prices and seeing limited policy success on the subject throughout most of his term, Trump reiterated his drug pricing ambitions this summer by unveiling a series of executive orders.

The international pricing index—also called the “most-favored-nations" clause—would tie U.S. prices in Medicare to lower prices abroad. The pharmaceutical industry has intensely resisted the proposal. Eli Lilly CEO David Ricks, for one, characterized it as “horrible” policy, and Pfizer CEO Albert Bourla, Ph.D., said the president’s summer executive orders on drug pricing were “an enormous distraction” amid the COVID-19 fight and threatened American jobs.

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On the flip side, many in the industry have voiced support for the administration’s aim to crack down on rebates to middlemen in Medicare.  

After the administration rolled out those orders and more this summer, the new rules to be unveiled Friday are in final form, WSJ reports, meaning they can be implemented right away.

Still, a spokeswoman for pharmaceutical industry trade group PhRMA told Reuters the group is “considering all options” to halt the international pricing index. And, since President-elect Joe Biden is set to be inaugurated in two months, it’s unclear whether his administration will keep the rules in place, according to the news service.

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While the Trump administration has made several attempts to crack down on high drug prices during his term, there could be another unique aspect to this week’s move. Politico reports that the president is upset Pfizer’s COVID-19 vaccine data didn’t come until after the election and that there could be an element of retribution playing into the administration’s considerations. Trump clashed with Pfizer back in 2018 over the company’s decision to raise drug prices midyear, and the company pledged to delay its hikes in response.