Trump prescription plan doesn’t include Medicare-negotiated pricing

DATE: May 14, 2018

Published by McKnight’s LTC News

President Donald Trump’s “blueprint” for lowering prescription costs goes after pharmacy benefit managers but stops short of recommending Medicare-negotiated prices, a plank he campaigned on in 2016.

Though Trump on Friday afternoon called for eliminating the middlemen who “became very, very rich” negotiating prices for insurers and large employers, the 45-page plan offers no specifics as to how he’ll limit the role they play.

PBMs have come under increasing scrutiny since the president’s economic advisory council issued a February report that highlighted their dominance in senior healthcare settings.

Some critics said Trump’s new focus on PBMs allows drug makers to slip off his radar, and industry stocks rose after the speech — a sign that pharmaceutical investors didn’t feel threatened by Trump’s plan.

The Senior Care Pharmacy Coalition has long called for stricter controls. In a statement made just before Trump’s speech, the group lauded the administration’s “objective assessments of a drug pricing marketplace and regulatory framework failing consumers and failing our nation.”

Coalition President and CEO Alan G. Rosenbloom expressed concern about a dramatic round of mergers and acquisitions among insurance companies, PBMs, distributors, providers and others resulting in “worrisome consolidation.”

Other seniors advocates called the blueprint a good first step, though some had hoped the president would empower the government to play a larger role in price setting.

“AARP has long supported … allowing the Secretary of Health and Human Services to negotiate lower drug prices on behalf of millions of Medicare beneficiaries,” Executive Vice President and Chief Advocacy & Engagement Officer Nancy LeaMond said in a statement.

AARP leaders said they also hoped to see Trump address drug imports, reduce exclusivity for high-priced biologic drugs, prohibiting pay-for-delay deals between brand and generic drug companies, and demand greater transparency.

The blueprint, which raised a series of questions about the drug-pricing chain and touted Trump’s previous budget initiatives aimed at Medicare Part D reform, moved away from many of the specific proposals he touted while campaigning.

The president does want stricter policing of delay tactics, to make advertisements more transparent about pricing, and to stifle gag clauses that prevent some consumers from learning about rebates and lower-priced drug alternatives.

“The drug lobby is making an absolute fortune at the expense of American consumers,” Trump said. “We are putting American patients first.”