President Donald Trump is set to deliver his first major speech on drug prices on April 26, revisiting an issue he campaigned on but that is unlikely to yield major legislative changes.
The strategy is unlikely to call for actions of the sort Trump touted on the campaign trail like allowing the government to negotiate the cost of drugs for Medicare, but based on the president’s fiscal 2019 budget request could advocate for Medicare and Medicaid demonstrations to test new ways of paying for drugs on a smaller scale, like allowing some states to try negotiating drug costs in Medicaid.
Trump’s remarks are expected to coincide with a formal request for information from HHS on various drug pricing ideas, according to White House deputy press secretary Hogan Gidley.
The cost of prescription drugs has been a top concern of Republican and Democratic voters since before Trump was elected. Recent polling the Kaiser Family Foundation found that 80 percent of the public thinks prices are unreasonable and more than half believe bringing costs down should be a “top priority” for the White House and Congress. Yet, only 39 percent expressed confidence that the administration will deliver.
The administration’s drug pricing strategy is unlikely to call for major legislative changes, sources said — a recognition that there’s little appetite in Congress to take up any potentially controversial proposals ahead of November’s midterm elections.
Despite calling out drug companies and Trump’s past assertion the industry is “getting away with murder,” the administration has been criticized for pushing policy ideas that would actually benefit drugmakers and do little to touch the industry’s bottom line.
Trump’s 2019 budget proposal included a wide array of changes to Medicare and Medicaid aimed at tackling the cost of medicines. The ideas would save the government $5.72 billion over a decade, according to the Office of Management and Budget, though some of the proposals would increase taxpayer spending.
One proposal that has been popular with Trump’s HHS officials would require Medicare Part D drug plans for seniors to share the savings from drug rebates with patients, would cost the government about $42.16 billion over 10 years. The policy would likely lead to higher premiums, which the government subsidizes. But it would benefit those patients with high drug costs. This idea has been pushed by the powerful brand-name drug lobby PhRMA, which argues companies are providing generous discounts on drugs that insurance companies are not sharing with patients.
Another idea that lobbyists believe the administration may advance is letting Medicare Part D plans negotiate drug costs for certain drugs in Medicare Part B. HHS Secretary Alex Azar had repeatedly suggested that the Part B payment systems should be made more market-based.
Sources familiar with the coming announcement said new ideas to be broached include plans for FDA to help increase access to cheaper forms of expensive biologic medicines known as biosimilars.