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A2 UP FRONT
Saturday 2 February 2019
Trump health chief asks Congress to pass drug discount plan

By RICARDO ALONSO- Think people with cancer,
ZALDIVAR patients with intractable
WASHINGTON (AP) — The illnesses such as multiple
Trump administration's top sclerosis or rheumatoid ar-
health official asked Con- thritis, and those who take
gress on Friday to pass its brand-name medicines
new prescription drug dis- with no generic competi-
count plan and provide it tion. Patients' cost sharing
to all patients, not just those is often based on list prices,
covered by government not the cost of the drug af-
programs like Medicare. ter rebates.
The plan would take now- "Simply put, those on no
hidden rebates among medications at all will just
industry players like drug see their premiums go up
companies and insurers and see no savings be-
and channel them directly cause they don't take
to consumers when they any medicine," said Bach.
go to pay for their medica- "Those on generics only
tions. may be essentially in this
Patients with high drug co- category (as well).
pays stand to benefit from "But those on expensive
the proposal, while people medications ... they will
who take no prescription see savings in total," he
drugs, or who rely on gener- In this Oct. 26, 2018, file photo Health and Human Services Secretary Alex Azar speaks about added. More than half a
ics mainly, would probably proposed reforms to Medicare Part B drug pricing policies at the Brookings Institute in Washington. million people filled at least
pay somewhat more, since Associated Press $50,000 in prescriptions in
premiums are expected to 2014, according to an Ex-
rise. and Medicaid beneficia- tank. insurers and middlemen press Scripts report.
A day after unveiling the ries. Ahead of next week's State called pharmacy benefit Insurers and pharmacy
plan as a proposed regu- "Congress has an oppor- of the Union speech, Presi- managers to negotiate re- benefit managers like Ex-
lation, Health and Human tunity to follow through on dent Donald Trump is un- bates among themselves. press Scripts and CVS op-
Services Secretary Alex their calls for transparency der political pressure to Drug companies pay re- pose the administration
Azar raised the stakes by ... by passing our proposal show results for his promise bates to make sure their plan, saying it will under-
calling on Congress to into law immediately and to slash prescription drug medications are covered cut their ability to bargain
make it law and broaden it extending it into the com- costs. Data show that pric- by insurance plans that with drugmakers for lower
to include people covered mercial drug market," Azar es for brand-name drugs are the intermediaries be- prices.
by employer health insur- said in a speech at the Bi- have continued to rise, tween them and patients. Drugmakers have ap-
ance, not just Medicare partisan Policy Center think though at a somewhat HHS says hidden rebates plauded the administra-
slower pace. Polls show can amount to up to 30 tion's action.
consumers across the politi- percent of a drug's list Consumers are worried
cal spectrum want govern- price. Insurers say they use about prices for brand-
ment action. the money from rebates to name drugs, particularly
Democrats say the admin- hold down premiums for all new medications that
istration's plan doesn't go consumers. promise breakthrough re-
far enough because it still Under the plan, the current sults. Generics account for
leaves drug companies anti-kickback exemption nearly 90 percent of pre-
free to set high list prices. for industry rebates would scriptions filled, but brand-
They say drug pricing is like be replaced with a new name drugs account for
a black box, and it's impos- one for discounts offered more than 70 percent of
sible to tell if prices reflect directly to consumers. the spending.Azar con-
actual costs or if compa- Azar said the idea would tends that under the cur-
nies are charging what reshape the drug pric- rent system everybody but
they think the market will ing system, shifting it away the patient benefits from
bear. from hidden rebates to high prices. A high list price
House Speaker Nancy Pe- upfront discounts, creat- makes room for bigger ne-
losi, D-Calif., says she's also ing pressure on drugmakers gotiated rebates for insur-
worried that the plan would to keep prices down. The ers and middlemen. And
raise premiums. HHS ac- proposal was co-authored drugmakers then merely
knowledges Medicare pre- with the HHS inspector gen- build that expectation into
scription premiums would eral's office. their prices.
go up $3 to $5 a month. Experts say it will take time Before joining the Trump
Nonetheless, the adminis- to sort out all the potential administration, Azar was
tration's proposal appears consequences. a top executive for drug-
to be in the mix as Con- Peter Bach, director of the maker Eli Lilly. That led to
gress gears up to craft leg- Center for Health Policy criticism that he would be
islation addressing prescrip- and Outcomes at New an industry pawn. But the
tion drug costs. York's Memorial Sloan Ket- drugmakers vehemently
The complex plan would tering Cancer Center, said disagree with some of his
work by doing away with the current system of re- other ideas, including an
an exemption from federal bates harms patients who experiment using lower in-
anti-kickback rules that cur- take costly drugs with high ternational drug prices to
rently allows drugmakers, copays. cut some Medicare costs.q