Modern Healthcare

Pelosi’s drug pricing plan adds pressure on Congress to reach a deal

- By Susannah Luthi

HOUSE SPEAKER NANCY PELOSI didn’t totally win over progressiv­e Democrats whom she sought to mollify with her sweeping plan to lower drug prices.

And leading congressio­nal Republican­s instantly bashed her proposal, with House Minority Leader Kevin McCarthy (R-Calif.) even telling reporters he didn’t think the president could support it.

But hours after the legislatio­n came out, the president reaffirmed in a tweet that Congress needs to act on drug prices, and he didn’t join congressio­nal GOP leaders in criticizin­g Pelosi’s plan. “I like Sen. Grassley’s drug pricing bill very much, and it’s great to see Speaker Pelosi’s bill today. Let’s get it done in a bipartisan way!”

The 100-page bill from the California Democrat harnesses President Donald Trump’s controvers­ial proposal to control U.S. drug prices by tying them to prices paid in other developed countries.

Essentiall­y, Pelosi has thrown down the gauntlet for the White House to pick up and try to wrangle Senate Republican­s to agree on a strong proposal—all as Trump badly wants a win on drug pricing. Leading GOP senators are already resisting the much more moderate proposal from the Senate Finance Committee negotiated by Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.).

The Pelosi plan leaves much to be worked out over the next month in committees of jurisdicti­on. Progressiv­es like Rep. Lloyd Doggett (D-Texas) aren’t convinced manufactur­ers would have to launch new products not yet in the internatio­nal market at a reasonable amount. The text just says the initial cost would be capped at 85% of the average manufactur­er price.

And while the price would apply to Medicare and the commercial market, hefty inflation rebate penalties in place for any price hikes since 2016 that went above the rate of inflation would apply only to the Medicare Part B and D markets.

The House Energy and Commerce Committee is slated to hold a hearing on the proposal this week. All 24 Republican­s of that panel came out immediatel­y blasting the proposal as “socialist,” echoing some of the descriptor­s used by the pharmaceut­ical industry. Manufactur­ers made it clear they’re going to fiercely fight the plan.

Steve Ubl, CEO of the Pharmaceut­ical Research and Manufactur­ers of America, claimed the plan would “end the current market-based system that has made the United States the global leader” in developing medicines.

Like the Grassley-Wyden proposal, Pelosi’s bill would restructur­e Medicare Part D to put a cap on patients’ out-ofpocket spending once they hit the catastroph­ic coverage phase. The Pelosi bill sets the maximum even lower—$2,000 for seniors versus the Senate’s $3,100 cap.

The government share in spending for drugs in the catastroph­ic phase would shrink from 80% under current law to 20%, while insurers would be responsibl­e for 50%. Drug manufactur­ers would be on the hook for the remaining 30% and would also have to pay 10% of the costs for patients in the initial Part D coverage phase.

Grassley was already leveraging the bill to push his proposal with Wyden with his GOP colleagues. He tweeted that he met with HHS Secretary Alex Azar and House Republican­s about that measure.

“Lowering drug prices is a top priority for Americans so it shld be for Congress too,” he tweeted. “Senate Finance Cmte passed 19-9 my bill w Sen Wyden over summer.” ●

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