Trump order on drug prices faces long road to finish line

Trump order on drug prices faces long road to finish line
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President TrumpDonald TrumpTrump PACs brought in over M for the first half of 2021 Chicago owes Trump M tax refund, state's attorney mounts legal challenge Biden hits resistance from unions on vaccine requirement MORE is seeking a preelection boost on a top issue for voters — lowering drug prices — but there are doubts about when and if his latest move will bring down costs for patients.

Trump signed a long-awaited executive order Sunday that aims to lower the amount Medicare pays for many drugs by tying the cost to the price tag in other developed countries.

While the move could significantly cut the price for certain drugs, the timing of Trump’s action means implementation is unlikely before Election Day.


The Department of Health and Human Services (HHS) still needs to issue regulations for the order, a process that can sometimes take several months. After that, establishing an entirely new system of Medicare purchasing will require even more time.

The White House has not always exhibited a sense of urgency on the issue, one that Trump talked about on the 2016 campaign trail. Trump announced an earlier version of the same policy just weeks before the 2018 elections, but the proposal was stalled for almost two years before being revived on Sunday.

“It would be extremely difficult and hard to imagine this getting implemented before the election,” said Tricia Neuman, a Medicare expert at the Kaiser Family Foundation.

“It would have been a different ballgame had the administration put these proposals out and moved them forward earlier in his term,” she added.

The pharmaceutical industry, which strongly opposes the price restructuring, arguing it would lead to painful payment cuts that would harm innovation, quickly said it could sue to try to stop Trump’s order, adding the possibility for further implementation delays.

But if it eventually goes through, Trump’s order could dramatically cut the prices for some high-cost drugs.


In the meantime, Trump’s intentions put congressional Republicans in an awkward position. Most of them oppose the move as an embrace of “price controls,” but they are also hesitant to publicly criticize Trump, particularly in an election year.

Democrats, meanwhile, are also in the odd position of having proposed something similar to Trump’s order, which they largely attacked as purely symbolic and a preelection stunt.

Rep. Lloyd DoggettLloyd Alton DoggettGOP leans into racial issues ahead of midterms Democrats under new pressure to break voting rights stalemate Biden rips Trump's 'big lie' in voting rights address MORE of Texas, a leading Democratic advocate for action on drug prices, called it “empty election-eve magic” after “failing to lower any prices during almost four years.”

“Trump aims to make a misleading headline for his failing campaign, not a genuine difference for victims of price gouging,” Doggett said.

David Mitchell, founder of the advocacy group Patients for Affordable Drugs Now, tweeted that the move is “good” and can remedy Americans paying two to three times what people pay for drugs in other wealthy countries.

But he added: “None of us should expect to see lower prices for months or years or maybe never. Many critical questions remain unanswered. A similar proposal has been sitting within the Admin for two years.”

Avik Roy, a right-leaning health policy expert, pushed back on the idea that the move is merely “symbolic” but also acknowledged in an op-ed in Forbes that it will likely take “another year” for the new payment system to be set up, once the regulations are issued.

Roy pointed to the similarities between what Trump has proposed and drug pricing proposals from Democratic presidential nominee Joe BidenJoe BidenThe Supreme Court and blind partisanship ended the illusion of independent agencies Missed debt ceiling deadline kicks off high-stakes fight Senate infrastructure talks spill over into rare Sunday session MORE, raising the question of whether Biden would allow Trump’s order to move forward if he is elected.

The Biden campaign did not respond to a request for comment.

House Democrats, in their signature drug pricing bill passed in December, proposed a similar system of capping drug prices based on prices paid in other countries, while allowing the HHS secretary to negotiate prices down even further.

The Democratic bill is significantly broader, though, in that it would apply to people with private insurance plans as well, not just those on Medicare.

After months of talks between the White House and Speaker Nancy PelosiNancy PelosiOn The Money: Justice Department says Trump's tax returns should be released | Democrats fall short of votes for extending eviction ban House adjourns for recess without passing bill to extend federal eviction ban Photos of the Week: Olympic sabre semi-finals, COVID-19 vigil and a loris MORE’s (D-Calif.) staff last year on a possible agreement on drug pricing, discussions broke down and Trump officials threatened to veto the House bill, echoing the industry argument by warning it would harm innovation.

The White House backed a more modest measure in the Senate, from Sens. Chuck GrassleyChuck GrassleyBiden's bipartisan deal faces Senate gauntlet The Hill's 12:30 Report - Presented by Facebook - US gymnast wins all-around gold as Simone Biles cheers from the stands The Hill's Morning Report - Presented by Facebook - A huge win for Biden, centrist senators MORE (R-Iowa) and Ron WydenRonald (Ron) Lee WydenDemocrats warn shrinking Biden's spending plan could backfire Democrats release data showing increase in 'mega-IRA' accounts Senate Democrats press administration on human rights abuses in Philippines MORE (D-Ore.), but Trump never put political muscle into persuading Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellBiden's bipartisan deal faces Senate gauntlet The Hill's Morning Report - Presented by Facebook - Biden sets new vaccine mandate as COVID-19 cases surge Democrats warn shrinking Biden's spending plan could backfire MORE (R-Ky.) to schedule a vote. Efforts to advance that bill have similarly stalled.

Congressional Republicans reacted carefully to Trump’s latest order.

Rep. Greg WaldenGregory (Greg) Paul WaldenEx-Sen. Cory Gardner joins lobbying firm Ex-Rep. John Shimkus joins lobbying firm Lobbying world MORE of Oregon, the top Republican on the House Energy and Commerce Committee, did not take a firm position but said he’s “confident [HHS] will consider the impact any action taken could have on the innovation our country is counting on to end the COVID-19 pandemic and to develop cures and treatments for other diseases.”

Rep. Kevin BradyKevin Patrick BradyRepublicans focus tax hike opposition on capital gains change GOP, business groups snipe at Biden restaurant remarks Top Democrat offers bill to overhaul tax break for business owners MORE, the top Republican on the House Ways and Means Committee, was more explicit in raising concerns about the impact on innovation. Brady and Walden both pointed to more modest drug pricing legislation that their party has proposed.

“We believe a lasting legislative solution will achieve the President’s goal without the downside of importing foreign price controls that slow down the development of new medical cures,” Brady said in a statement.

Rachel Sachs, a health law expert at Washington University in St. Louis, said there are a range of administrative steps and lingering policy questions that would delay the move from taking effect.

Those obstacles, coupled with the fact that the previous version sat on the shelf for almost two years, make the likelihood of final implementation before the election slim at best.

“The administration hasn’t displayed a sense of urgency about this before,” Sachs said.