Keep negotiating drug prices
Democrats and Republicans are clear in polls that they want government to be allowed to negotiate down high drug prices. Americans pay nearly three times as much for drugs as patients in dozens of other countries. In the past two years, numerous Democratic candidates—including President Joe Biden—have campaigned on enacting such legislation.
This year, the polling group at KFF asked respondents about support for drug-price negotiations after giving them the commonly offered arguments: On the pro side, lower prices mean people can better afford their medicines; on the con side, lower profits mean the possibility of less innovation and fewer new drugs.
Large majorities—83 percent overall—supported the idea of Medicare negotiating with pharmaceutical firms to get lower prices for beneficiaries and people with private insurance. In recent polling funded by the Robert Wood Johnson Foundation, 84 percent of respondents said the government should be allowed to put limits on prices for drugs that save lives and for common chronic illnesses like diabetes.
Why are the Democrats settling on a menu of halfway measures to address high drug prices?
The current proposal on drug prices in Biden’s Build Back Better spending package with support from Congress (so far) contains nice consumer protections such as limiting out-ofpocket prescription drug payments for Medicare beneficiaries to $2,000 annually and limiting yearly price increases.
But when it comes to allowing the government to negotiate better prices, provisions are byzantine. The government would identify 100 high-cost medicines and choose 10 for price negotiation annually, with those prices first taking effect in 2025. It could only negotiate about medicines that had been already on the market for at least nine to 13 years, depending on the drug type.
The benefits of such a program are diffuse, affecting patient pocketbooks here and there.
On the other side, PhRMA regards drug-price negotiation for Medicare a threat to its business. It spent $23 million on lobbying in the first nine months of the year.
As public support for price negotiations has gained momentum in the past few years, PhRMA’s campaign donations have been directed to the few sympathetic or moderate Democrats it needed on its side to prevent drug price negotiation written into law.
Though Sen. Kyrsten Sinema of Arizona had made bringing down the cost of prescription drugs a campaign issue in 2018, she helped block a more ambitious House proposal from moving forward that would have allowed Medicare to negotiate prices of 250 drugs and extend those prices to those with other types of insurance. She received about $100,000 in campaign contributions from the industry in 2019-20.
Then there is the further problem that Democrats have a thin majority in both houses of Congress, and key Democrats like New Jersey’s Sen. Bob Menendez and Rep. Scott Peters of San Diego represent states or districts with many drug manufacturers.
Finally, the image of the pharmaceutical industry has been somewhat burnished by its role in developing covid-19 vaccines and drugs, an accomplishment it has deployed this fall as an argument to head off price limitations.
Politicians and many health experts did their best to see a glass-half-full in the plan put forward by the Democrats and the president. Senate Majority Leader Charles E. Schumer called it “a massive step forward,” though he noted in the same breath that “Many of us would have wanted to go much further.”
So would most voters, public surveys show.