June 29,2020

ICYMI: NYT on the Status of Prescription Drug Pricing Reform

By Noah Weiland

New York Times

June 27, 2020


When President Trump visited Senate Republicans last month for the first time since the coronavirus pandemic began ripping across the country, Senator Charles E. Grassley, the powerful chairman of the Finance Committee, confronted him about whether he still wanted to fulfill his years-old promise of lowering the cost of prescription drugs.


“You started this whole process,” said Mr. Grassley, an Iowa Republican who had drafted such a plan, and whom Mr. Trump had taken to calling early in the morning to discuss the issue. “Are you still interested in signing a bill?”


The president said that he was, according to a person in the room that day, adding that the Senate had “no choice” but to act. …


Millions of Americans, including droves of newly unemployed, are stuck with increasing out-of-pocket costs for medication in the middle of a historic health crisis. But the political will to address the issue appears to have faded away.

Now Mr. Grassley, working to salvage the effort, is planning to call for his bill to be included in the next round of coronavirus relief legislation that Congress is expected to consider later this summer, according to a senior Republican aide.

“All of the problems that pre-existed the pandemic are still there, if you’re paying too much for insulin, if you’re paying too much for cancer drugs like I am,” said David Mitchell, who founded Patients for Affordable Drugs and is battling a blood cancer called multiple myeloma. “Nothing has changed, except now we have millions of people who are unemployed who have lost income, who have lost insurance.”

Many Republicans in Congress who have fretted about the political risks of their party’s push to repeal the Affordable Care Act, which the Trump administration on Thursday asked the Supreme Court to overturn, had hoped for action on drug costs, eager to show voters that they were willing to address the most pressing health care problems. Mr. Grassley said that during his town hall meetings in Iowa before the pandemic, a quarter of the time was spent discussing prescription drugs.

Prescription medicine use has only intensified during the coronavirus crisis: Express Scripts, a prescription benefit manager with over 100 million customers, saw spikes in March for three-month refills and new prescriptions for conditions associated with higher coronavirus risk.

Mr. Mitchell said that his group had observed significant price increases on drugs needed for coronavirus patients, including anticoagulants for blood clots.

Mr. Grassley’s bill would cap the growth of drug prices in Medicare at inflation level, and impose a $3,100 limit on out-of-pocket costs for tens of millions of seniors and Americans with disabilities enrolled in its drug coverage program. The plan would provide nearly $100 billion in savings, according to the Congressional Budget Office.

Lowering drug prices is the rare issue for which Americans support more government intervention. Majorities of Democrats and Republicans believe Congress should do more to regulate drug prices. A majority of Americans say they would even accept higher taxes and fewer new drugs being developed if it mean paying less for prescription drugs.


The public’s mood is reflected in Washington, where lowering drug prices has been one of the few causes with broad bipartisan support in Congress, giving the issue momentum in a Senate with a thin legislative record. Every Democrat on the Finance Committee voted for Mr. Grassley’s bill, and the dozen Republicans who have pledged support cover the ideological spectrum, from Senator Steve Daines of Montana, a conservative ally of Mr. Trump’s, to the more moderate Senator Susan Collins of Maine. Both are running for re-election this year, as are Senators Joni Ernst of Iowa and Martha McSally of Arizona, who also back the bill.


Mr. Grassley has lobbied other Republicans on the Senate floor this year, making the pitch that he represents a possible last chance for a measured plan. His Republican successor on the finance committee, Senator Michael D. Crapo of Idaho, may be unfriendlier to reform if Mr. Trump wins a second term, and a Democratic administration, he has said, would pass something even less desirable.


But Mr. Grassley and his colleagues have yet to find a compromise with House Democrats, and the measure has stalled since its approval by the Finance Committee. Democratic and Republican aides in the House and Senate privately say that Mr. Trump, notoriously fickle and uninformed on policy, could hasten a resolution with a phone call to Mr. McConnell, but he has chosen not to do so. Vice President Mike Pence and Alex M. Azar II, the health secretary, have endorsed the legislation.