Latest news with #MedicareDrugPriceNegotiationProgram
The Hill
4 days ago
- Health
- The Hill
With his new prescription drug order, Trump fixes what Biden broke
Americans have been clamoring for sensible prescription drug reform for years. With the stroke of his pen, President Donald Trump answered that call. His executive order aims to bring down drug prices while 'once again putting Americans first.' Luckily, it specifically addresses one of the serious flaws in the Biden administration's Medicare Drug Price Negotiation Program — an oversight that has discouraged investment in affordable, widely used medications. This reform could deliver major savings to patients — without undermining the innovation that drives medical breakthroughs. Now it's up to Congress to finish the job. The reform in question addresses a flaw in the Medicare price-setting scheme put in place by the 2022 Inflation Reduction Act. That law gave the secretary of Health and Human Services sweeping new authority to impose price controls on certain drugs covered by Medicare. But it also drew an arbitrary line between different types of medicines by giving biologics, which are made from living organisms,13 years before price-setting kicks in, while small-molecule drugs, like pills and capsules, get just nine. That four-year gap makes no clinical or economic sense. Many of the most important drugs in history, from aspirin to statins to HIV treatments, are small-molecule medicines. Yet innovators are now steering investment away from them. According to a recent study, investment in small-molecule drugs has already dropped by 68 percent. And compared to pre-IRA levels, new small-molecule cancer drug development programs fell over 40 percent last year. President Trump's order calls for correcting this imbalance. The Republican-backed EPIC Act offers the clearest solution, aligning the treatment of small-molecule drugs with biologics by extending the price-setting window to 13 years. My hope is that this legislation will pass quickly with bipartisan support. Passing EPIC would protect innovation, preserve patient access and deliver on the president's promise to fix what the last administration got wrong. The order also directs the secretary of Labor to write new transparency rules to address some of the other significant issues affecting drug access and prices. That's a big win for patients and a critical step toward restoring fairness to the system and decreasing out-of-pocket costs for Americans. In addition to these transparency reforms, the order acknowledges the critical role of intellectual property rights in bringing new drugs to patients — and promises to optimize those protections in ways that improve access and lower drug costs. Patents and other intellectual property protections play a central role in pushing medical science forward. The previous administration's efforts to undermine these essential tools posed a direct threat to the foundations of America's innovation-driven economy. President Trump's unequivocal stance on this issue should come as welcome news to the nation's inventors and entrepreneurs — including those in the biotech sector. Equally encouraging is the executive order's treatment of the 340B Prescription Drug Program. The program was originally designed to help safety-net providers offer affordable medications to low-income patients. Yet today, less than 40 percent of hospitals that use the program are in underserved areas. During my time in Congress, I took up this issue — championing reforms to promote transparency, increase accountability and require participating hospitals to report patient's benefits. Now, emboldened by the White House, lawmakers should do the same. Altogether, this order is a blueprint for drug pricing reform that's patient-focused, pro-innovation and rooted in real-world solutions. Now, Congress can do its part, beginning with passing the EPIC Act. If they do, American patients could finally get the kind of affordable, innovative and equitable prescription drug sector they've long demanded. Larry Bucshon, MD, a cardiothoracic surgeon, served as the U.S. representative for Indiana's 8th District from 2011 to 2025.
CBS News
12-05-2025
- Business
- CBS News
Trump ordering that the U.S. to pay only the price other nations do for some drugs
President Trump on Monday called on drugmakers to lower their prices within the next month to be closer to those charged in other high-income countries, threatening to subject them to steep caps on how much they can earn from Medicare if they fail to do so. "Starting today, the United States will no longer subsidize the healthcare of foreign countries, which is what we were doing, we're subsidizing others' healthcare, in countries where they pay a small fraction of what, for the same drug, that what we pay," the president told reporters Monday at the White House. Mr. Trump told reporters that "some prescription drug and pharmaceutical drug prices will be reduced almost immediately by 50% to 80% to 90%," and "big pharma will either abide by this principle voluntarily or we'll use the power of the federal government to ensure that we are paying the same price of other countries." The president said his move marks an expansion of the "most favored nation" idea from his first term, when the Centers for Medicare and Medicaid Services set steep price caps tied to the prices charged in other developed countries for how much it would pay for some prescription drugs. "It's called most favored nation," Mr. Trump said. "We are going to pay the lowest price there is in the world. We will get, whoever is paying the lowest price, that's the price that we're going to get." At the time, that proposal applied only to drugs given by providers in hospitals and clinics through Medicare Part B — not the broader swath of prescriptions that seniors fill at drug store pharmacies. Medicare said it would only pay hospitals and doctors for a price based on the lowest amount paid among developed countries. A report by the Trump administration during its first term found that the U.S. spends twice as much as some other countries on covering those drugs. Medicare Part B drug spending topped $33 billion in 2021. That idea was blocked by the courts during Mr. Trump's first term, after the administration shortcutted "rulemaking" steps to try to rush to implement the proposal in its final days. The Biden administration later formally abandoned the proposal and sought instead to curb drug costs through the Medicare Drug Price Negotiation Program created by Congress. Under the new version of Mr. Trump's "most favored nation" proposal, the White House says it will seek to develop new rules to revive the price caps in Medicare, in addition to a new "mechanism" to allow Americans to buy drugs directly from manufacturers at this price. Drug manufacturers that "fail to offer most-favored-nation pricing" voluntarily will have the prices imposed on them through new rules, which the White House says it is directing the Department of Health and Human Services to propose. Over the next month, CMS Administrator Dr. Mehmet Oz said the administration is planning to approach "pharmaceutical companies to talk specifically about what we want the most favored nation price to be, based on the best data we have." "We're looking forward to a thoughtful interaction with these corporate leaders, many of whom we've spoken to and in quite will agree, the system is not right the way it is," Oz said. It's not yet clear which drugs will be included in the president's push, although he mentioned the "fat shot drug" as potentially one of them. A CMS spokesperson was not able to immediately respond to a request for comment, asked about how the agency was determining which drugmakers to approach and what the pricing would be. White House officials said ahead of the announcement that they were looking for price reductions in drug costs across both federal and private health insurance, not just Medicare. No specific class of drugs is being targeted, they said, but they are planning to focus on drugs with the biggest disparity between U.S. and foreign prices. Americans pay significantly more than citizens of other countries do for many of the same pharmaceutical drugs. Experts have blamed it on a range of factors, including a complex web of insurers, middlemen and providers that underpin the U.S. healthcare system, unlike other countries, which set prices through government-run healthcare systems. The drug industry has opposed "most favored nation" pricing as a "deeply flawed proposal," calling it "importing socialized medicine" and claiming it could upend small and mid-size biotech companies in the U.S. "Applying other countries' antiquated approach to how they value – and pay – for medicines will stall investment across America's biotech companies, risk access to vital treatments and cures for millions of American patients, and lead to fewer American jobs," John F. Crowley, president of the Biotechnology Innovation Organization, said in a statement Monday. The pharmaceutical industry argued that Mr. Trump's 2020 attempt would give foreign governments the "upper hand" in deciding the value of medicines in the U.S. The industry has long argued that forcing lower prices will hurt profits, and ultimately affect innovation and its efforts to develop new medicines. and contributed to this report.
Yahoo
02-05-2025
- Health
- Yahoo
Opinion: An unfair penalty on life-saving pills
There are times when government interventions create unanticipated negative consequences. Such is the case with what has become known as the 'pill penalty' that resulted from the Biden administration's Inflation Reduction Act (IRA). The IRA imposed a system of price controls on certain medications commonly used by millions of American seniors through Medicare Part D through the Medicare Drug Price Negotiation Program. This program is hardly negotiation, but rather a set of targeted price controls. Congress, in legislating a price control scheme, created a disruptive division between types of drugs. The details are complicated, but the result is different treatment for two major types of drugs that has created growing market distortions and disparities. Most common prescriptions come in pill or capsule form. Generally, pills are less costly and easier for patients to take. That means they are more likely to be used consistently, a key factor in managing chronic diseases like diabetes. Medicines in pill or capsule form are called 'small molecule' drugs. 'Large molecule' drugs, or 'biologics,' often cost more. Many are administered by health workers in a clinical setting through infusions, or patients can self-administer injections. All these forms of administration are far less convenient for patients to take. Also, these drugs are often indicated for rare diseases or those that are more difficult to treat. The problem is that Congress subjected small molecule drugs to price controls four years sooner than large molecule drugs. That inequality is known as the 'pill penalty' and has led to a disparity in investment for research and development between the two drug classes. The pill penalty is already having a profound effect throughout the biomedical industry, including here in Utah. Investment in pill-form, 'small molecule' research and development (R&D) has dropped as much as 70%, as investment dollars shift to the more profitable 'large molecule' sector, or 'biologics.' Since the passage of the IRA, dozens of research projects on the pill side have been scuttled as capital naturally migrates over to more profitable products. Not only will fewer 'small molecule' medicines be produced because of ill-conceived government action, those that exist now may not ever be fully developed. Over half of small molecule drugs that have been approved in decades past have later been cleared by the FDA for additional uses, such as treating other maladies or for pediatric use. Post-approval research is key for developing new uses and/or improving formulations. Without further research and testing, those additional benefits will be lost. The good news is that Congress can help reverse these unforeseen negative consequences with a proposed bill that recently won the support of the White House. In an executive order, President Trump has called upon Congress to fix the pill penalty. It is vital to codify the proposed changes with congressional action. The Ensuring Pathways to Innovative Cures (EPIC) Act is now moving through Congress, hopefully on a bipartisan basis. The EPIC Act will do away with the pill penalty and put both small and large molecule medicines back on a level playing field. The fix is easy enough — others can debate the wisdom of government price controls, but if we must have them, it only makes sense to treat small and large molecule drugs equally. That will fix the bias against typically lower cost pill-form medicines and restore investment dollars to their development. We at Bio-Utah are grateful to Sen. John Curtis for becoming a co-sponsor of the EPIC Act. We also invite other members of Utah's federal delegation to join Sen. Curtis in supporting the EPIC Act, including as co-sponsors if possible. The problems that emerged from the IRA have created unintended harms for the pharmaceutical industry. The EPIC Act is a great way to resolve one of those harms.
Associated Press
17-04-2025
- Health
- Associated Press
NASP Applauds President Trump for Efforts to Reduce Drug Pricing and Address Necessary PBM Reforms
Washington, DC, April 17, 2025 (GLOBE NEWSWIRE) -- President Trump issued an Executive Order titled Lowering Drug Prices by Once Again Putting Americans First on Tuesday, April 15. The Executive Order called for the Administration and Congress to continue efforts from the first Trump Administration to reduce prescription drug costs. Included in the Executive Order is a plan to address the Medicare Drug Price Negotiation Program, including improvements in the transparency of the program and reducing negative impacts to the pharmaceutical industry. The Executive Order also calls for a review of the role of Pharmacy Benefit Managers (PBMs). 'NASP is appreciative of President Trump's continued effort to reduce the drug costs of American seniors. NASP encourages the Trump Administration to ensure that implementation of the Drug Price Negotiation Program does not cause harm to specialty pharmacies who serve some of the sickest Americans.' NASP President and CEO Sheila Arquette, RPh stated. 'Specifically, we encourage the Trump Administration to ensure that specialty pharmacies are not left holding the bag as they seek to support patients. Pharmacies must be paid in a timely manner for drugs they dispense through the drug price negotiation program, and must not be reimbursed below the cost to dispense.' 'NASP appreciates the White House's want to address the anticompetitive practices of some PBMs. For far too long, specialty pharmacies have faced practices by some PBMs that make it impossible for specialty pharmacies to participate in networks, eliminating patient access to the specialty pharmacy of their choice. We have long been advocating for the passage of federal legislation to address these concerns. We call on the Trump Administration to ensure reform occurs through executive action, regulation or via legislation this year. 'NASP wants to also emphasize the importance of the 340B program in supporting low-income medication access for those with specialty conditions and funding chronic disease management programs. We caution against any reforms that would negatively impact the program, participating pharmacies and the patients served.' ### NASP represents all specialty pharmacy industry stakeholders. Specialty pharmacies serve communities of patients who have complex health conditions like cancer, rheumatoid arthritis, multiple sclerosis, cystic fibrosis, hemophilia, organ transplantation and rare diseases. Specialty pharmacies are accredited by an independent, third party nationally recognized accreditation organization ensuring consistent quality of extensive drug management and clinical patient care services. Sheila M. Arquette, RPh National Association of Specialty Pharmacy (NASP) (703) 842-0122 [email protected]
Yahoo
17-04-2025
- Health
- Yahoo
Trump's executive order seeks to lower prescription drug prices, including for Medicare
April 17 (UPI) -- President Donald Trump has ordered the Department of Health and Human Services to standardize Medicare payments in an effort to curb prescription drug prices, including with private insurers. "Combined, these bold actions were delivering real savings for American patients and set the foundation to dramatically narrow the price disparity between the United States and foreign nations over time," said the executive order that Trump signed Tuesday. This directive to HHS Secretary Robert F. Kennedy Jr. comes as Trump seeks to impose specific tariffs on pharmaceutical imports on top of other ones, including a baseline 10% for most trading partners. Market research group Black Book Research found that 84% of experts predict that prices for medical treatments and drugs will rise due to the tariffs, according to a survey released in February. Between January 2022 and January 2023, prescription drug prices rose more than 15% and reached an average of $590 per drug, according to the Department of Health and Human Services in 2023. Of the 4,200 drugs on that list, 46% of the increases exceeded the rate of inflation. In 2024, the United States imported $213 billion in medicines, which is 2 1/2 times higher than a decade earlier, with Germany, India, Ireland, Singapore and Switzerland major suppliers of pharmaceuticals. Major drug companies outside the United States include Teva in Israel, Novo Nordisk in Denmark, AstraZeneca in Britain and Novartis in Switzerland. U.S. companies are Eli Lilly, Merck, Pfizer, Roche and Johnson and Johnson. "We don't make our own drugs anymore," Trump told reporters Monday. "The drug companies are in Ireland, and they're in lots of other places, China." Trump wants to equalize Medicare payments for drugs, including the treatment of cancer, regardless of where the patients get care. The White House in a fact sheet said the directive can lower costs by as much as 60%. Also, Medicare payment for certain prescription drugs that hospitals pay for would be matched, which can result in 35% lower costs than what the government pays to acquire those medications. And sought: lowering insulin prices for low-income patients or those who are uninsured to as little as 3 cents and injectable epinephrine for treating allergic reactions to as low as $15. In 2022, President Joe Biden signed into law the Inflation Reduction Act, which included requiring Medicare Part D plans to charge no more than $35 per month for all covered insulin products, and also limits cost sharing for insulin covered under Part B to $35 per month. The Medicare Drug Price Negotiation Program allows Medicare to directly engage in negotiating prescription prices with drug companies. Private insurers do this. Trump wants to improve on the 22% in savings that the Biden administration achieved, according to a White House fact sheet. "The guidance shall improve the transparency of the Medicare Drug Price Negotiation Program, prioritize the selection of prescription drugs with high costs to the Medicare program, and minimize any negative impacts of the maximum fair price on pharmaceutical innovation within the United States," the order said. Also, the Food and Drug Administration was asked to work with Congress to quicken Medicare price negotiations for biosimilars, which are complex biologic medicine, compared with small molecule drugs, typically pills. "My first term included numerous significant actions, including some of the most aggressive in recent history, to deliver lower prescription drug prices to American patients," Trump said in the order. "The message was clear: no longer would the executive branch sit idly by as pharmaceutical manufacturers charged patients in our Nation more than those in other countries for the exact same prescription drugs, often made in the exact same places." During Trump's first administration, states were allowed to more easily import drugs from Canada and required federally qualified health centers, to pass along discounts they receive on insulin and EpiPens to their patients. The Biden administration ended the rule for health centers, citing the excessive administrative costs and burdens imposed on them. CMN reported the measures didn't result in making medications more affordable.
