In the speech, delivered Thursday afternoon at the Department of Health and Human Services, Trump excoriated other countries for what he called "freeloading" off of American biopharmaceutical innovation by forcing American patients to pay more for drugs than their overseas counterparts.
Health Secretary Alex Azar said President Trump's bid to tie what the USA government pays for certain Medicare drugs to what other nations pay won't cripple innovation or access to vital treatments, even if the plan is one of Big Pharma's "ultimate nightmares".
Such a reaction was anticipated by the Trump administration, which has recently sought to show more action on its promises to take on rising drug prices.
This supports a recently released HHS report, which found us drug prices were almost twice as high as those in foreign countries.
Trump is linking the prices Americans complain about to one of his longstanding grievances: foreign countries the president says are taking advantage of US research breakthroughs. Same company, same box, same pill, made in the same location, and you will go to some countries and it will be 20 percent [of the cost of drugs in the United States] because of what we pay and in some cases, much less than that.
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"This is a huge policy change and one that has great potential to reduce the prices that taxpayers for these drugs and Medicare beneficiaries pay for these drugs", she said. "In other words, Americans pay more so other countries can pay less, very simple".
A pharmacist fills a prescription drug order at a pharmacy in Chicago, Ill.
Currently, Medicare pays the average list price (ASP) for Part B drugs plus 6%, to compensate providers for the costs of administration and maintaining inventory - the so-called "buy and bill" model.
Such a scenario could fundamentally change the nation's political approach to health care, making it much more likely that additional states would move to expand Medicaid coverage for low-income Americans and push back on efforts by administration efforts to relax regulatory standards. This is not fair, the president said, adding that this happens because the government pays whatever price the drug companies set, without any negotiation whatsoever.
And drug companies are not going to "walk away" from the world's largest payer for prescription drugs, Azar argued. The United States is the biggest funder of research and development in the pharmaceutical sector, yet now lacks the bargaining power to bring prices down - unlike in countries with public health-care programs. "President Trump asked us to fix this problem and here's how we plan to do it". The new prices would be pegged to an "international pricing index" based on the average sales price in other countries with economies comparable to that of the United States. If the drug were priced using the formula the agency wants to use in the future, spending that year would have been about $1 billion less. It won't affect prices for drugs dispensed at pharmacy counters. In contrast, Part D spending on drugs has risen much more slowly.
Shortly after Trump's speech, pharmaceutical industry lobby group PhRMA said it opposed the changes, which it said would limit access to drugs for cancer and chronic conditions like rheumatoid arthritis.
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The HHS study, for example, shows that the US spent about $1.7 billion in 2016 on Rituxan, a drug made by Biogen Inc. that treats non-Hodgkin's lymphoma. The report notes Part B is not subject to restrictions on the drugs that are covered, meaning there is little incentive to tamp down costs.
Donald Trump may be trying to direct voters' attention to a migrant caravan in Central America, but he also knows it's a health-care election. In a March Kaiser Family Foundation poll, eight in 10 respondents said drug costs are unreasonable and 92 percent said passing legislation to bring down the cost of prescription drugs should be a top or important priority.
Using private-sector vendors to supply physicians and hospital outpatient departments with drugs and biologicals is another significant change from the current Medicare reimbursement system for Part B drugs. But it's largely been business as usual for drugmakers even as Trump has predicted "massive" voluntary price cuts.
Some experts said this policy - if it's implemented - could have a big impact on drug prices.
President Donald Trump's new pledge to crack down on "the global freeloading" in prescription drugs had a sense of déjà vu.
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