Sometimes it is a good idea to know that the law of political gravity still works. Donald Trump is canceling all institutions that render legal residents to foreign prisons and tank the world economy, protect and benefit from the world economy with unproductive tariffs. But he still must act as if he is deeply interested in lowering the price of Americans.
This was AN’s topic Executive order It is released on Tuesday and suggests some steps to reduce the cost of patient. Unlike other EOs that simply violate federal laws and constitutions, there are many presidents that the president can legally do at the price of pharmaceuticals. The government is one of the largest pharmaceutical researchers, a patent grant to prescription pharmaceutical companies, and health systems such as Medicare and Medicaid. This provides many authority and leverage strengthened by the provisions of the inflation reduction method. Medicare allows for negotiations on drug prices.
But instead, Trump’s main actions this week were torn at the story of the drug industry. Despite the drop in the price of medicines, the administration has actually a specific proposal. Lift up them.
More than David Dayen
This problem is at least known as “pill penalty” for the industry lobbyist. The IRA’s drug pricing program includes a delay period that provides more time to set prices to pharmaceutical companies and avoid negotiations with Medicare. The delay period from the market launch to the time when the negotiation price comes into effect is 9 years for the so -called “small molecules” drugs, often in the form of tablets or capsules, and biologically 13 years, which is generally more complicated.
The pharmaceutical company argues that this is unfair because the monopoly of price for four years is more attractive for biologists. Thus, research expenditures say that drifting on this sector avoids innovation in small molecular drugs that treat chronic diseases for more patients.
This is a typical industry claim. Reducing profits will have unintended consequences. And his Executive orderTrump repeats wholesale even the stupid phrases that the industry came up with. “This inconsistency threatens to distort innovation by investing in expensive bio products,” ORDER says.
Biologically expanded monopoly period is Add the last minute To IRA, which was pushed by the democratic allies of the biotechnology industry. If you think it’s a problem, there are many ways to deal with it. For example, reducing biological delays to completely eliminate the delay or to equal time frames. BIDEN officials have proposed to reduce the delay for both biological and small molecular drugs to five years with multiple budgets.
“This represents another bite constraint in Apple.”
But the solution of the Trump administrative order is exactly the opposite. Extend Since it is a delay of small molecular drugs, Medicare negotiations are more immunity due to these drugs. Steven Knievel, an advocate for public citizens’ pharmaceutical programs, said, “This indicates that constraints indicate another bite in apology. More than half Already in the Medicare price negotiation process, small molecular drugs are already not qualified and the price should be low.
Specifically, this command instructs Robert F. Kennedy Jr. to “cooperate with parliament to match the treatment of small molecular prescription drugs with the treatment of biological products.” that Existing Republican Act This will achieve this by increasing the delay of small molecular drugs, and you can easily insert it into the big reconciliation bill.
This change is said to be combined with other reforms to prevent the increase in overall costs for Medicare and beneficiaries. The expansion of the delay period Increase Prescription for Medicare and beneficiaries. Of course, which one will be if you have to wait four more years to negotiate the price for this drug?
According to A press release In the Ron Wyden Senator (D-Or), this change will increase Medicare costs $ 10 billion. If you determine the completely removing the delay period, the cost is much higher. Remember that this should be an administrative order. lowering Pharmaceutical price.
The delay was the main wish of the pharmaceutical industry. According to the source, the lobbyist bonus is associated with securing this clause. Chief Company CEO I ate with Trump and RFK I met Trump at Mar-Lago in January Several times After inauguration. Pharma has spent more than other sectors in the last 20 years. Open secret.
To offset the cost of getting more prices, the pharmaceutical industry can be willing to accept changes that can prevent them. Consumer advertising direct advertising cost deduction In their taxes, the source says view. RFK and others are pressing the pharmaceutical company with consumer advertising anyway. However, eliminating the possibility of deductions can only be expensive to the government. There is nothing for consumers who still have to pay higher prices due to the industry’s special deal.
Most of the remaining administrative orders include measures that Trump attempted to enact or enact at the first term, notable omission. It is not specific for increasing transparency on Medicare Price negotiations, testing new payments for high -cost drugs, making Medicare drug payments equal in other provider positions, and stabilizing Medicare Part D Premium. Overseas, the first Trump program that BIDEN has maintained, is required to improve the income of prescription drugs. There were few acquisitions of the government.
Article 7 of this command tries to force the 340B program for low -income patients to provide insulin or epinephrine for another first reuse. Ryan White Clinics Pointed out During the first term, this misunderstands the operation of the 340B program. Already, you cannot refuse to treat all the discounts for that purpose and to treat what you can’t pay. By switching 340B directly to a discount program, there is a way to give more benefits to the patient, but Trump does not require.
Among the missing parts of the order is the actual crackdown on the pharmacy benefit manager. During the first term, Trump removed the vaults that legalized the dynamics between PBMS and pharmaceutical companies, which contribute to the rise in drug prices. The White House mentions safe port removal. Administrative order facts sheetBut I do not want to replicate the practices abolished by Congress. Instead, this command requests the recommendation for PBMS within 90 days and requests the regulations on the release of the right substitute, the rebate release.
Last year, the PBM reform, which was agreed with, was a year -end expenditure bill before buying. Blocked by the committee. main It’s as conservative as Arkansas Although they are doing something about PBM by preventing vertical combinations, Trump and Republican Congress have little interest.
Another missing reform is the so -called “most preferred country” status. In the first semester, Trump proposed an international reference price system and proposed to end the difference in prices in other industrialized countries that Americans paid for prescription drugs. There was a demonstration project in 2020, but it did not go forward. Trump during the campaign Promise in the video In the prescription, “Global Free Loading End”. But the video was taken later, and the “most preferred country” is not part of this administrative order.
Finally, Doge’s efforts to reduce government capabilities collide with administrative orders. Trump Almost 20 % It will be almost impossible to accelerate any FDA personnel, including support staff for review and approval.
Trump It is expected to be absorbed Most of these costs do not help to lower pharmaceutical prices, and pharmaceutical companies with the president’s ears can resist other price lowering strategies.
In a sense, the main proposal for pharmaceutical prices is strange. During the ridiculous assault on democracy and the rule of law, the basic handouts for their preferred industries were noticeable. It is better to see the joy of the Republican Party we all know and love. As Knievel said, “This is to carry old -fashioned enterprise water.”
