President Donald Trump's long-awaited plan to bring down drug prices, unveiled Friday, will mostly spare the pharmaceutical industry he previously accused of "getting away with murder" and instead focus on increasing private competition and requiring more openness about costs.
"When foreign governments extort unreasonably low prices from USA drug makers, Americans have to pay more to subsidise the enormous cost of research and development", Trump said in a major policy speech in the Rose Garden of the White House. The effort comes as a growing number of Americans struggle with the cost of their medications, and cite healthcare concerns as a top priority for Washington ahead of congressional elections in November.
President Trump said he wants to eliminate "the middlemen" in that system.
He also said it is unlikely that countries will be cowed by administration demands about pharmaceuticals.
Drugmakers accuse pharmacy benefit managers, or PBMs, of profiting off higher list prices because they can negotiate bigger discounts.
"Everyone involved in the broken system - the drugmakers, insurance companies, distributors, pharmacy benefit managers and many others - contribute to the problem", Trump said, adding that even the government has been a part of the problem, referring to the way "previous leaders turned a blind eye" to rising costs. "We are not going to reward companies that constantly raise prices, which in the past has been most companies".
At the time, he said the government should negotiate drug prices for government health programmes, such as Medicare.
Critics said the policies pointed to the influence the pharmaceutical industry wields with the administration.
Health care analysts and observers were - well, lets' just say underwhelmed by Trump's presentation, with many saying that the details of the blueprint didn't live up to the president's tough talk. "Because those incentives are driving it", Azar said.
Shares of drug stocks rose after the president's speech, with Merck & Co. up 2.8% and Regeneron Pharmaceuticals Inc. up 6.2%.
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"When foreign governments extort unreasonably low prices from US drugmakers, Americans have to pay more to subsidize the enormous cost of research and development".
A summary of the blueprint, dubbed "American Patients First", mentions pharmacy benefit managers but does not include any proposals directly aimed at them. The plan also calls for streamlining and speeding up the approval process for over-the-counter drugs.
There are also steps that require drug manufacturers to publicly disclose list prices for their drugs in advertising, particularly on television.
"This plan will lower prices in the near term and continue to lower prices in different ways over the next several years", said Sen.
He said one new proposal would allow senior citizens enrolled in Medicare who hit the catastrophic period to pay nothing out of pocket, "so really relieve a huge burden on our senior citizens". "There are a bunch of smaller technical changes", said Sam Richardson, Associate Professor of Economics at Boston College.
"The notion that if other countries pay more for drugs that United States consumers will pay less, that's just not true", he said.
Health and Human Services Secretary Alex Azar, a former pharmaceutical company executive, said numerous actions the government was considering would not require approval by Congress and could take place through executive action within months.
"This weak plan abandons the millions of hard-working families struggling with the crisis of surging drug prices", said Rep. Nancy Pelosi, D-Calif.
Earlier this week, Swiss drugmaker Novartis admitted it paid $1.2 million to a consulting firm created by Trump lawyer Michael Cohen.