As Congress returns, lawmakers rush to detail drug-pricing agendas

DATE: January 9, 2019

Published by STAT News

WASHINGTON — Chuck Grassley wasted little time this week in unveiling his drug-pricing agenda, attaching his name to a trio of bills that, as the new chair of the Senate Finance Committee, he is freshly empowered to advance.

Grassley, an Iowa Republican, was among the many lawmakers who hurried to announce bills to lower drug costs, many of which have stalled in past sessions but that now enjoy renewed enthusiasm, as President Trump and Democrats on Capitol Hill continue their pharmaceutical industry focus.

Topping the list: a bill Grassley proposal with Sen. Amy Klobuchar (D-Minn.) that would allow Americans to import drugs from Canada for personal use — a proposal Grassley has previously supported but had been championed by the late Sen. John McCain.

Grassley said Wednesday that he would bring back two other bills on the topic with Democrats: the CREATES Act, which aims to crack down on anticompetitive behavior from brand-name manufacturers, and a bill to ban the practice of “pay-for-delay,” when companies pay generic manufacturers to delay production of off-patent drugs, as two other top priorities.

Grassley, speaking at a Wednesday roundtable with reporters, also said he would examine potentially anticompetitive practices involving insurers and pharmacy benefit managers.

Grassley — who is not seen as a drug industry ally — largely expressed support for the Trump administration’s drug-pricing agenda. But he signaled preliminary opposition to health secretary Alex Azar’s proposal to align reimbursements for prescription drugs with foreign prices, but said he would wait until a public comment period had closed before responding formally.

“Initially, I don’t want foreign countries setting our drug prices,” Grassley said. “What can he do to modify that, so that principle isn’t violated?”

Even legislation that typically has enjoyed the support of only Democrats was unveiled this week as a bipartisan effort: a bill from Rep. Peter Welch (D-Vt.) to allow Medicare’s prescription drug benefit to negotiate prices directly with manufacturers.

Its new co-author this Congress: Rep. Francis Rooney, a Republican who, in a statement, said it was an “unconscionable abuse to the American people that pharma does not compete for drugs provided under Medicare Part D.”

Grassley, one of the authors of the 2003 legislation that created Part D, said he would consider a finance committee examination of whether pharmaceutical companies are “gaming the system” of charging Medicare, but that he remained opposed to allowing the health secretary to negotiate with manufacturers directly.

“I feel very strongly that we don’t mess with that, based on the proposition that Part D is the only federal government program I’ve ever been involved in that has come in under budget,” Grassley said.

Sen. Bernie Sanders (I-Vt.), a frequent and vocal critic of the drug industry, is also set to unveil his own drug pricing proposals on Thursday, one of which is is conceptually similar to the Trump administration international reference pricing proposal.

Sanders’ version, which includes a provision that could strip drug companies of exclusive licenses if negotiations stall, enjoys the co-sponsorship of Reps. Ro Khanna (D-Calif.) and Elijah Cummings (D-Md.), the chair of the House Oversight Committee. Cummings has indicated he will aggressively police the industry, telling STAT last week he would likely call drug industry executives before Congress to testify about high drug costs, calling drug pricing his “no. 1 priority.”

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