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Nancy Pelosi's drug price plan would take on Big Pharma

illustration of a bill rolling onto the capitol building
Illustration: Aïda Amer/Axios

A draft of House Speaker Nancy Pelosi's drug pricing plan obtained by Bloomberg Law confirms that she's working on an aggressive proposal that would give the government vast new authority.

Between the lines: The proposal would give Medicare the authority to negotiate the prices of 250 drugs, limit how high these prices could be based on how much other countries pay, and establish harsh penalties for drugmakers who refuse to comply.

  • This largely aligns with what my colleague Sam Baker reported last weekend.
  • "The document is an out of date draft. Nothing is being distributed to the Caucus yet because the Committees are still discussing," said a senior Democratic aide.

Details: Pelosi's plan would...

  • Allow the HHS secretary to negotiate the prices of the most expensive 250 drugs without at least 2 competitors. This price would be available to all payers, not just Medicare beneficiaries.
  • Set the maximum price of a drug at 1.2 times what other wealthy countries pay for it.
  • Steeply fine drug companies if they don't participate in the negotiation process or abide by the agreed-on price.
  • Require drug companies that have raised the price of drugs covered by Medicare by more than the inflation rate since 2016 to either lower the price or pay a rebate to the government.

What we're watching: Whether the White House shows any interest in a plan this aggressive — which would be dead on arrival in a traditional GOP administration.

Go deeper: The Trump-Pelosi mind meld on drug costs