Jul 26, 2019

Trump's next move on lowering drug prices

Phot: Chip Somodevilla/Getty Images

The White House is preparing another big executive order on drug prices, Reuters scooped last night.

The big picture: Citing industry sources who had discussed the plan with the administration, Reuters says that it would likely seek to lower prices in Medicare Part D, which covers drugs you pick up at the pharmacy counter. The administration's most sweeping proposal to date — to piggyback off of the lower prices in European countries — was limited to Part B, which covers drugs administered by a doctor.

  • It's not clear whether the new Part D proposal would also rely on international pricing, per Reuters. Part D is much bigger than Part B.

Between the lines: It's probably no coincidence that this threat is being floated just as the White House is trying to build support for the Senate Finance Committee's drug-pricing bill, despite Republican objections.

  • In fact, Sen. Chuck Grassley made that point explicitly, The Hill reports.
  • "Who knows what he's going to do at the last minute,” he said, referring to Trump. “If he would join forces with Pelosi, look at what that would do to everything that we Republicans stand for."
  • “It seems to me that the Grassley-Wyden approach is a very moderate approach [compared] to what could come out,” he added.

Where it stands in the Senate: Finance approved the Grassley-Wyden bill yesterday, but the proceedings left no doubt that there are still stark divisions within the GOP over drug pricing, and more resistance than we're used to seeing on policies Trump supports.

The intrigue: Nine of the committee's 15 Republicans voted against the bill. All of the Democrats supported it, leading to a final vote of 19-9.

  • The bill's proposal to cap price increases within Part D is clearly the biggest sticking point for Republicans. An amendment to strike that provision, offered by Sen. Pat Toomey, failed on a 14-14 vote.

What's next: Pharma's best bet is probably to stop the Senate from passing anything.

  • That would prevent an eventual conference between the House and Senate, in which Pelosi and Trump could make good on Grassley's predictions and strike up an alliance (if she wanted to help Trump claim a win on drug prices, which is far from a sure thing).
  • But that's a tall order, so expect pharma and its allies to keep trying to water down the Senate package while waging that bigger-picture fight.

The bottom line: “This bill is not anywhere near action on the floor,” Sen. John Cornyn (R-Texas) said yesterday, per The Hill.

Go deeper: Axios' Deep Dive on drug pricing

Go deeper

How Democrats want to limit drug prices

Illustration: Rebecca Zisser/Axios

The Democratic presidential candidates' plans to lower drug prices are much more aggressive than what the party has supported in the past.

Between the lines: There are big differences among the candidates' platforms, but the entire debate has shifted to the left.

Go deeperArrowAug 8, 2019

Sanders visits Canada with diabetes patients to buy cheaper insulin

Democratic presidential candidate Sen. Bernie Sanders outside a pharmacy in Windsor, Canada. Photo: Scott Eisen/Getty Images

Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) traveled with health advocates, including diabetes patients, to Windsor, Ontario, Sunday to illustrate how much less insulin costs at pharmacies in Canada compared to the U.S., CBC reports.

Why it matters: Per Axios' Bob Herman, stories about U.S. patients dying from rationing insulin have put the drug at the center of the debate on how the country will lower prices for essential medicines.

Go deeperArrowJul 29, 2019

Importation isn't a silver bullet to lower drug prices

Illustration: Sarah Grillo/Axios

The Trump administration is moving forward on the traditionally Democratic policy of importing prescription drugs from abroad, but the impact — if the proposals are actually finalized — could be pretty muted.

The big picture: While importation could help some patients afford their drugs, the policy overall is an attempt to take advantage of other countries' lower drug prices while avoiding taking direct action to limit prices in the U.S.

Go deeperArrowAug 1, 2019