Under a bill introduced

by Democrats Rep. Lloyd Doggett of Texas and Sen. Sherrod Brown of Ohio, the government could approve a generic competitor if a branded-drug manufacturer doesn’t agree to a reasonable Medicare Part D price for a given medication. This would give teeth to HHS Secretary Alex Azar’s mandate to negotiate prices, but avoids the controversy of excluding certain drugs from coverage under Part D. Analysts frequently point out that effective negotiation would require Medicare to be able to refuse to cover certain high-cost medications. Doggett and Brown’s proposal has about 100 Democratic co-sponsors. Genericdrug companies would pay royalties to the branded-drug manufacturer if their product is approved.