- The Washington Times - Thursday, May 10, 2018

President Trump is set to propose the most comprehensive plan to tackle prescription drug prices in history, the White House boasted Thursday, setting a high bar for an upcoming address in which Mr. Trump plans to put “American patients first” by cracking down on “freeloading” by foreign nations and requiring Medicare to give a leg up to seniors.

Senior administration officials say developed nations tamp down drug prices for their own citizens, knowing they can rely on Americans to subsidize the costly research that goes into developing life-savings cures here at home.

Yet Mr. Trump, who just rattled Europeans by withdrawing from the Iranian nuclear deal, plans to lean on other nations again by outlining ways he can force foreign consumers to pay more in a major Friday address.

Officials were reluctant to say how they would pull that off, building anticipation for the speech by Mr. Trump, a former reality-TV star who relishes high ratings and suspense.

Still, they said many of the changes can be done by Mr. Trump administratively, without relying on a highly polarized Congress in a midterm election year.

Rising drug prices were a key campaign issue for president in 2016 — at one point, he said pharmaceutical companies were “getting away with murder” — and poll after poll suggests soaring prescription costs are a major concern for voters.

But the administration has faced sharp criticism for taking little action to deal with the problem, even as Congress hauled the makers of EpiPens and other critical drugs to Capitol Hill for a scolding over what their constituents and government programs like Medicaid fork over for vital medicines.

Health and Human Services Secretary Alex M. Azar II assured Congress on Thursday that Mr. Trump’s proposals will be serious and far-reaching.

“The president will be rolling out a comprehensive plan around drug pricing that addresses all aspects of the channel including the role of the pharmacy benefit manager, drug companies, others in the system,” Mr. Azar told the Senate Appropriations Committee.

Mr. Trump will stop short, however, of calling for using federal powers within Medicare to directly negotiate down the prices of drugs — something Democrats have insisted on for years, saying the candidate who vowed to “drain the swamp” should be able to take on Big Pharma, a major GOP donor.

The Pharmaceutical Research and Manufacturers of America spent nearly $10 million federal lobbying during the first year of 2018, underscoring the stakes of Mr. Trump’s address.

Administration officials said the address will focus on four areas — insisting on higher prices abroad, so Americans can pay less; slashing list prices for drugs; reducing out-of-pocket costs; and giving seniors a better deal under Medicare.

For instance, low-income seniors would get free generic versions of drugs under his plan and the government would tie price increases for drugs under Medicare Part B to the rate of inflation.

The administration also says it wants to crack down on companies who “game” the patent system by denying competitors the information they need to develop generics.

Mr. Trump is also expected to target pharmacy benefit managers (PBMs), who negotiate drug discounts and rebates from pharmacies and manufacturers on behalf of commercial health plans and self-insured employers. The administration says the higher list price, the higher the rebate that PBMs get, so they want to reconfigure incentives so that consumers win out.

Democrats probably won’t be impressed, however.

They say Mr. Trump is unwilling to take on major pharmaceutical companies, which used savings from the GOP tax for stock buybacks instead of lowering prices. And they’ve been quick to point out that Mr. Trump’s health secretary — Mr. Azar — is a former pharmaceutical executive.

“We proposed allowing the government to negotiate for lower drug prices, and to establish an office that would go after the most egregious companies and actors that are raising prices of drugs for no reason — a price gouging enforcer,” Senate Minority Leader Charles E. Schumer said Thursday. “If we were in the majority, these policies would be one of our top priorities. Hopefully, President Trump will get on board.”

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