Ban on negotiating Medicare drug prices under pressure
As a participant, she wants to pay less for her medicines, which cost her about
“You know from working in a business that it makes no sense for an administrator of a plan or a company not to be involved in what they have to pay out,” said Weiner, who lives near
Negotiating Medicare drug prices is the linchpin of President
To do that,
When lawmakers created Medicare's Part D outpatient prescription drug program in 2003, they barred Medicare from negotiating prices.
“I don't know of any other situation where the government has one hand tied behind its back when dealing with people like big pharma,” said Sen.
Known as the “noninterference clause,” the ban has been unbendable. That's the way the pharmaceutical industry wants to keep it.
Former Medicare administrator
Drugs costing tens of thousands of dollars a month were rare when the prescription benefit was enacted nearly 20 years ago. Now they have become more common, and
Their legislation also would limit price increases for established drugs and cap annual out-of-pocket costs for Medicare recipients such as Weiner. Another part would overhaul the inner workings of the nearly
Politicians including former President
And it still might not happen.
Similar to the rest of Biden's massive agenda, authorizing Medicare to negotiate hinges on a few Democratic holdouts. During committee deliberations in the House, three
Amid a furious lobbying and advertising campaign, the
Business groups and the pharmaceutical industry are opposed. Drug companies have spent
The industry says weakening the ban on negotiations would stifle investment in innovative ideas that can lead to lifesaving cures.
“The United States simply put is the bio-pharmaceutical engine for the world,” said
PhRMA opposes constraints on launch prices for new drugs, as well as limitations on price increases for existing medicines. It says the government has other ways to shield Medicare recipients from high out-of-pocket costs and blames insurers for not passing manufacturer rebates directly to patients.
Joldersma points to research by the nonpartisan
PhRMA says the chilling effect would be deeper.
“If you are the patient ... it is certainly not a marginal issue,” said Joldersma.
Others say it's unlikely that drug development would shrivel. Valuable medicines would go forward, but ones with fewer benefits would have a harder path, said biotethicist said Dr.
“The big argument is at if the government lays a finger on the process, somehow that is going to stifle innovation,” said Pearson. “We can get even better innovation by being smart in how we pay."
Responded industry official Joldersma: “I’m not aware that
One of the biggest industry objections is that the House bill would use lower prices in other advanced counties as a yardstick for Medicare. The Trump administration tried a similar idea with a different set of Medicare medications. Drugmakers say
A recent
Other countries try to balance incentives for research and development with prices that reflect the value to patients and society, said study author
“If we just wrote a huge check to drug companies, would they do more research?" Mulcahy asked. “Probably some. But is that the socially optimal thing to do? Probably not.”
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