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The Health 202: White House is reviewing a new index to cut Medicare drug spending

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June 26, 2019

Eight months ago, President Trump vowed to bring federal payments for some Medicare-covered drugs more in line with lower prices for the medicines in other countries. It was a move that struck many as especially aggressive for a GOP administration but meshed with Trump’s vow to lower the price of prescription drugs.

A proposed rule for the experimental international pricing index is being reviewed by the White House Office of Management and Budget as of Thursday, indicating the Department of Health and Human Services is finally moving forward on it after some delay.

There’s enthusiasm inside HHS for the index, which would tie the prices for drugs covered by Medicare and distributed by doctors to an average of lower prices paid in 16 other countries, where the government plays a much more active role in setting prices. But the drug industry and some conservative groups are fighting hard against it, and Sen. Chuck Grassley (R-Iowa), head of the powerful Finance Committee, poured cold water on the proposal after holding his fire for months.

“I’m gaining a view that I don’t think that this administration’s approach on international pricing is going to be to the benefit of the adoption of and research for modern drugs,” Grassley told reporters on Wednesday. “I’ve been slow arriving at that conclusion … but I think I’ve studied it long enough now.”

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Trump visited HHS at the end of October to unveil the index idea, saying it would resolve a “rigged” system in which the United States pays more than other nations for medicines. The idea is to save the government money by reducing payments for prescription drugs dispensed through the part of Medicare that pays for doctor visits.

 While the index would apply to just a small percentage of the drugs paid for by Medicaid, it is one of the more robust actions the administration has proposed against skyrocketing drug prices. Last month, HHS finalized a rule requiring drugmakers to display the list price of medications in television ads. The agency is also working to finalize a rule essentially banning the rebates drugmakers pay to pharmacy middlemen, which are blamed for inflating list prices.

But the index proposal has particularly raised the ire of conservatives, who view it as akin to government price-setting.FreedomWorks has been especially vocal against the idea, dubbing it an “importation of foreign price controls.”

“It’s encouraging to see Senator Grassley come out to oppose the international pricing index,” said Dan Savickas, the group’s federal affairs manager. “No conservatives should entertain this idea and we need more legislators to come forward and publicly urge the administration to end their push for IPI.”

Pharmaceutical makers, which last year spent the most they had on lobbying since 2009, when the Affordable Care Act was being passed, are fighting hard, too. The index would result in delays for patients seeking medications, especially for cancer patients, the Pharmaceutical Research and Manufacturers of America wrote in a blog post earlier this month.

“It’s clear this far-reaching proposal would take the Part B program in the wrong direction,” wrote PhRMA’s Nicole Longo, director of public affairs. “We urge HHS to abandon the proposed demonstration and instead pursue reforms grounded in market competition and patient-centered care.”

The White House Office of Management and Budget noted the potential rule in its spring list of regulations that are in the works at HHS. The agency could provide more details in the regulatory agenda it is expected to release this summer.

Date: June 26, 2019

Source: The Washington Post

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