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Trump unveils plan linking drug payments to cheaper overseas prices




Trump first raised the possibility of linking prices to an international index as one of the ambitious proposals backed by his project in May 2018 to lower drug prices. But the idea, which sparked outrage for drug companies and split the GOP, stalled amid attempts to push through other promised policies, some of which failed in court or withdrew only the Republic’s scattered support.

Plan would link Medicare payments to 50 costly medicines administered in the doctors’ office, including costly therapies for cancer and rheumatoid arthritis based on a “mix formula” that includes the lowest internationally regulated price for the product among a group of OECD countries with GDP similar to those of the United States. Policy in addition to several providers, including children’s hospitals, cancer patients and critical care, plus rural health clinics, federally qualified health centers and Indian Health Service facilities.

The Trump administration plans to put the most-favored-nation rule in stages over the first four years, starting this January, of a seven-year model that gradually switches from the average selling price of a drug to the much lower estimated cost. from the formula.

In what appears to be an attempt to control pharmaceutical companies’ price increases in response to the rule, Medicare regulators said they would accelerate the four-year shift if U.S. prices rise faster than inflation and the price of most countries preferred.

The plan is almost certain to attract legal challenges because it was never formally proposed as a draft rule. A draft of the previous version, called the International Price Index, cleared the White House Office of Budget Management and Review on Nov. 19 after being under scrutiny for more than a year.

And while the administration estimates that the new plan could save Medicare $ 85.5 billion over those even years, it notes that part of the savings is attributed to beneficiaries who do not have access to their medicines through Medicare, along with the use of basically lost, fewer people having access to certain medications starting in 2023.

“PhRMA is considering all options to stop this reckless attack on companies working full-time to defeat COVID-19,” a spokesman said this week.

Discount rule

Trump also announced a plan to eliminate the discounts that drugmakers show when they justify high drug costs.

While the rule is a benefit to drug manufacturers, it is also likely to face legal challenges from payers opposing its release as a final rule, the Trump administration announced on the last possible day to clear a 60-day window before President-elect Joe Biden takes office.

The administration said patient savings could be nearly 30 per cent “under the new plan to eliminate the discounts pharmaceutical companies pay to pharmacy benefit managers.

But payers are prepared for the challenge of the new plan, arguing that the initial deduction rule was withdrawn last year. This move effectively restarts the process, which means that the administration must issue a draft plan and seek public comment before launching a comprehensive reform.

While the president instructed regulators this summer to review the rule so as not to cost patients or the government more money, the rule released Friday contains the same predictions as the original: That the deduction plan could cost up to $ 196 billion in government spending over a decade.

Drug manufacturers have long shown discounts as the invisible costs they pay push up drug prices. Pharmacy benefit managers, insurance advocates, and drug prices argue that eliminating the discounts included in plans plans which medications they prefer for patients takes away the leverage to control costs.

Reports from Office of Government Accountability and HHS Office of the Inspector General support the idea that discounts helped control spending on Medicare Part D.

But HHS Secretary Alex Azar, who once worked for drugmaker Eli Lilly, has long been a proponent of eliminating deductions from the system even when White House support was shaken.

“Any approach to the price of medicines that does not address the issue of discounts, whether through our proposed approach or otherwise will simply not lower the list prices,” he said last year. The secretary also argued that seniors’ premiums would not increase despite government forecasts they would make under the model because plans compete on the basis of low premiums.

Origin of the most favorite nations

Trump ordered federal officials this summer to work on a similar rule linking the prices of pharmacy-bought drugs in Medicare Part D to a basket of lower international costs, but with the clock ticking in his administration it is unlikely the plan subsequently, to include almost any other drug sold to consumers, will be shut down.

It is not clear how the most favored nations model or rule of descent under Biden administration would go through starting in January. President-elect Joe Biden has discussed setting up an independent review board to assess the value of medicines, another cost-cutting measure that would hit the pharmaceutical industry hard..

Trump first promised to reduce the high costs of prescription drugs in the wake of the 2016 campaign and a few days before his inauguration accused pharmaceutical companies of “getting away with murder.” But while price increases slowed during his presidency, medication costs ultimately did not fall. The rule announced Friday may be Trump’s consistent sign on the issue, but there may be a narrow path to completion between the legal battles and the Biden administration.

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