Sep 19, 2019

Pelosi releases her prescription drug plan

House Speaker Nancy Pelosi. Photo: Win McNamee/Getty Images

House Speaker Nancy Pelosi has put forward an aggressive plan allowing Medicare to negotiate the prices of some prescription drugs that could also be applied in the commercial market.

Why it matters: Under any other GOP administration, this plan would be dead on arrival. But Washington is waiting to see whether President Trump bites — and can then browbeat other Republicans into voting for it.

Between the lines: The framework of the plan is very similar to the draft that recently leaked, with changes likely made to appease various factions within the Democratic caucus.


  • The HHS secretary would identify 250 drugs without meaningful competition each year, and negotiate the prices of at least 25 of them. The negotiated price couldn't be more than 1.2 times what other countries pay for it, on average.
  • If a drug manufacturer refuses to negotiate, it'd get hit with an excise tax on annual gross sales beginning at 65% and increasing 10% every quarter that it remains out of compliance.
  • The manufacturer would be required to offer the negotiated price to commercial plans.
  • The plan also limits price increases in Medicare Part D and Part B to inflation (applied retroactively to 2016), creates an out-of-pocket spending cap in Part D, and restructures how Part D is paid for.

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

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Pete Buttigieg joins 2020 Democrats' leftward march on drug prices

Mayor Pete Buttigieg. Scott Olson/Getty Images

Pete Buttigieg released Tuesday his plan to reduce prescription drug prices, which includes many of the liberal proposals that have become the new Democratic normal.

Between the lines: This plan puts Buttigieg somewhere in the leftward middle of the top-tier candidates on drug prices. The field — and the party as a whole — is much more aggressive on the subject than Democrats have been in the past.

Go deeperArrowOct 8, 2019

Trump's smoke-and-mirrors 2020 health care strategy

Illustration: Sarah Grillo/Axios

President Trump may be telling voters everything that they want to hear when it comes to health care, but much of it isn't true.

Why it matters: Trump is claiming victories he hasn't achieved and making promises he's not prepared to live up to, all on an immensely personal subject that voters consistently rank as one of the most important issues of 2020.

New drugs are launching with ever-higher prices

Illustration: Eniola Odetunde/Axios

The average launch prices for new brand-name drugs have skyrocketed over the past decade, according to an analysis from drug research firm 46brooklyn.

Why it matters: The U.S. prescription drug market increasingly has thrived on high initial price tags and subsequent increases. That has resulted in higher premiums and out-of-pocket costs for new drugs, as well as more expensive generics.

Go deeperArrowOct 16, 2019