|
|
|
|
||
- What Big Pharma Fears Most: A Trump Alliance With Democrats to Cut Drug Prices The New York Times What Big Pharma Fears Most: A Trump Alliance With Democrats to Cut Drug Prices BYLINE: Robert Pear SECTION: US; politics WASHINGTON — The pharmaceutical industry, pilloried by President Trump for the last two years, is war-gaming for the possibility that its worst fear is realized: that Democrats, if they flip control of the House, find common ground with the president to rein in drug prices. Democrats say they are determined to squeeze the industry’s prices and profits, and they have a stack of legislative proposals that could do so. Drug makers are quietly making contingency plans. “As the midterm elections approach, a feeling of foreboding has settled over the pharmaceutical industry,” said John E. McManus, a Republican health care lobbyist whose clients include major drug companies, as well as their trade association, the Pharmaceutical Research and Manufacturers of America. “Combine the rising blue wave — the Democrat fixation on pharmaceutical pricing — with President Trump’s populist focus on getting credit for cutting patients’ drug costs, and the industry could be confronting a perfect storm in 2019,” Mr. McManus said. Soon after his election, Mr. Trump bucked his party and accused drug companies of “getting away with murder.” In May this year, he unveiled a blueprint to lower drug prices. He followed through this past week with a proposal to force drug companies to disclose list prices in their television advertisements. Democrats’ ideas include allowing Medicare to negotiate lower drug prices; putting a cap on Medicare beneficiaries’ out-of-pocket drug costs; requiring manufacturers to disclose and justify any significant price increases; and outlawing tactics used by brand-name drug makers to delay the development and marketing of lower-cost versions of their products. If Democrats retake the House, the gavel of the Health Subcommittee of the Ways and Means Committee could go to Representative Lloyd Doggett of Texas, an unyielding critic of what he calls price gouging by pharmaceutical companies. Drug companies say they are counting on the Senate — which political forecasters say is more likely to remain in Republican control — to stop legislation they oppose. But changes are coming there, too. Pharmaceutical companies will be losing one of their most powerful allies, Senator Orrin G. Hatch, Republican of Utah and the chairman of the Finance Committee, who is retiring after more than 40 years in Congress. He is likely to be succeeded as chairman by Senator Charles E. Grassley, an Iowa Republican who is more of a populist on health policy. In 2015, he and Senator Ron Wyden, Democrat of Oregon, issued a blistering report on their 18-month investigation of the high prices charged by Gilead Sciences for two hepatitis C drugs. Mr. Grassley has long supported allowing importation of prescription drugs from Canada — anathema to the industry. He wrote the provisions of federal law that require drug companies to disclose the payments they make to doctors for research, consulting, speaking, travel and entertainment. Mr. Grassley is also the foremost champion of whistle-blower laws, under which drug companies have paid billions of dollars to resolve allegations that they defrauded the government or engaged in illegal marketing practices. The challenges facing the industry were laid out in stark terms this month by Covington & Burling, a Washington law firm that has been advising pharmaceutical companies for more than 75 years. Rujul Desai, a lawyer, said in a webinar that the firm had done “war-gaming exercises” with senior drug company executives to prepare them for possible congressional investigations and hearings on drug prices. The goal, he said, is to help clients “communicate the value of their innovative medicines.” One of his colleagues at Covington, Jennifer L. Plitsch, explained how the government could try to use existing laws to force a reduction in the prices of drugs developed with the help of taxpayer funds. The government has rarely used this authority, Ms. Plitsch said, but that could change. “It is,” she said, “a very easy sound bite for price control advocates: Why should American taxpayers both contribute to drug development and then pay the highest prices in the world as patients?” She suggested how drug companies could answer that argument: “The sound bite is misleading and simplistic. The proposal would chill innovation and hurt patients. A vast majority of the investment in drug development comes from private industry, not the government.” The politics of drug prices cross party lines. Senator Richard J. Durbin of Illinois, the No. 2 Senate Democrat, was among the first to praise Mr. Trump’s plan to mandate the inclusion of drug prices in TV ads. Representative Jan Schakowsky of Illinois, a liberal Democrat, said she was “surprised and happy” to receive a phone call from the Trump administration notifying her of its price-disclosure proposal, which resembles a bill she introduced in July. “Despite their army of lobbyists,” Ms. Schakowsky said, “drug companies should be very, very worried. Drug costs will be one of the first things on our agenda.” Another Democrat poised to pounce is Representative Elijah E. Cummings of Maryland, who is in line to become chairman of the Committee on Oversight and Government Reform if Democrats take control of the House. In the last four years, he has aggressively investigated the industry, peppering drug makers and the Trump administration with numerous requests for information. Doctors, patients and insurers support many of the efforts to hold down drug costs. Researchers are making significant progress against cancer and other diseases, but “access is meaningless without affordability,” said Dr. Victor J. Dzau, the president of the National Academy of Medicine. Mr. Trump’s latest budget would provide Medicare beneficiaries with better protection against high drug costs by limiting their out-of-pocket expenses. Under another Trump proposal that could appeal to Democrats, Medicare beneficiaries would receive more of the savings that insurers extract from drug manufacturers. The Democrats’ proposal for the government to negotiate drug prices for millions of Medicare patients is their preferred solution. But it would also face the most opposition, from drug makers and Republicans who see it as a step toward price controls. As he campaigned for the presidency, Mr. Trump said he would “negotiate like crazy” to secure lower drug prices for Medicare. The idea — opposed by administration officials who have worked in the pharmaceutical industry — has dropped off his agenda. “President Trump has seemingly abandoned his campaign promise to have Medicare negotiate like crazy,” said Nancy Pelosi, the House Democratic leader. But, she added, “we hope he would work with a Democratic majority to deliver on negotiation authority and lower drug prices.” Drug companies seek to maintain their influence and access in the Capitol with campaign contributions and platoons of lobbyists recruited from both parties. The drug industry has contributed nearly $12 million to candidates in this year’s congressional races, about 60 percent of it to Republicans, according to data compiled by Kaiser Health News. That sum is dwarfed by the $267 million that drug makers report having spent on lobbying in 2017-18, according to the Center for Responsive Politics, an independent group that tracks money in politics. “Drug companies have been in such a strong position, and they have contributed so generously to people in both parties, they’ve been pretty well able to block anything,” Mr. Doggett said. “But I do believe that there is now a public outcry, a real pent-up demand, that we take action.” |
return to message board, top of board |