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Trump Signs Executive Order on Drug Prices

— PhRMA, others unhappy

MedpageToday
President Donald Trump signs an executive order in the oval office

WASHINGTON -- Drugmakers and some medical societies expressed disappointment over an President Trump signed Sunday designed to implement a "most favored nation" scheme for drug pricing.

"The administration has chosen to pursue the 'most favored nation' policy – an irresponsible and unworkable policy that will give foreign governments a say in how America provides access to treatments and cures for seniors and people struggling with devastating diseases," Stephen Ubl, president and CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA), . "What's worse is that they are now expanding the policy to include medicines in both Medicare Part B and Part D, an overreach that further threatens America's innovation leadership and puts access to medicines for tens of millions of seniors at risk."

Under the order signed by Trump, the Department of Health and Human Services (HHS) would test payment models for Medicare Parts B and D in which Medicare would pay for certain drugs not more than the "most favored nation" price, defined as "the lowest price, after adjusting for volume and differences in national gross domestic product, for a pharmaceutical product that the drug manufacturer sells in a member country of the Organisation for Economic Co-operation and Development (OECD) that has a comparable per-capita gross domestic product."

The executive order Trump signed Sunday replaces a similar one signed on July 24; that one gave pharmaceutical manufacturers until Aug. 24 to come up with an alternative to the "most favored nation" plan. However, no alternative materialized, resulting in Sunday's order.

The president tweeted his excitement about the order on Sunday afternoon. "Just signed a new Executive Order to LOWER DRUG PRICES!" . "My Most Favored Nation order will ensure that our Country gets the same low price Big Pharma gives to other countries. The days of global freeriding at America's expense are over ... and prices are coming down FAST!"

Notably, though, the order won't have any immediate effect: HHS must develop and promulgate a detailed policy, and litigation by drugmakers and others is a possibility. And the order only applies to drugs reimbursed by Medicare.

Rep. Lloyd Doggett (D-Texas), chairman of the House Ways & Means Health Subcommittee, panned Trump's action. "Trump proposes empty election-eve magic to miraculously lower drug prices 'FAST' after failing to lower any prices during almost 4 years," Doggett . "Typical Trump -- bluster and falsehoods, few details and multiple exceptions, while lowering drug prices for nobody this year. If only tweets and decrees could solve our problems. Trump aims to make a misleading headline for his failing campaign, not a genuine difference for victims of price gouging."

The Partnership to Improve Patient Care (PIPC), which includes patient groups, disability rights organizations, and provider groups such as the American College of Cardiology, American Academy of Nursing, and the American Osteopathic Association, expressed concern that the executive order would be harmful to patients with disabilities. "This executive order imports prices based on discriminatory metrics like the quality-adjusted life year, which devalue the lives of seniors, people with disabilities and serious chronic conditions," PIPC chairman Tony Coelho, a former Democratic congressman from California, . "Other countries use these metrics to ration healthcare. It is dangerous to import foreign pricing policies, and the associated access barriers that come with them."

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    Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.