The state of play on drug pricing and the election

With the House in recess and the Senate focused on impeachment, drug pricing appears to be on the backburner for now. However, POLITICO’s scathing account of Trump “lash[ing] out at HHS Secretary Alex Azar” over polling data showing voters “prefer Democrats” on health care could signal the need for a quick win from the administration.

Does that mean an international price index? Importation? We’ll keep you posted on what we hear. In the meantime, we spoke with BIO’s Federal Government Relations team for a deep dive into what can we expect in the months ahead.

The current state of play: In December, the House passed H.R. 3, Speaker Pelosi’s extreme drug pricing bill centered on an international price index, though Senate Majority Leader Mitch McConnell said it’s DOA in the Senate and Trump doesn’t support it, either, pushing instead for his plan to allow states to import drugs, primarily from Canada.

So, what now? Quite frankly, it’s difficult to say with impeachment sucking the oxygen out of the room.

There are a few possible avenues for the House to vote on key elements of H.R. 3—like surprise billing, or the May 22 deadline to renew funding for community health centers—which is why it’s important to keep up the drumbeat about reckless drug price controls.

What about the Senate? H.R. 3 will never pass, and the Senate Finance Committee bill remains an open question; Finance Chair Chuck Grassley (R-IA), surprisingly, met with Speaker Pelosi to see if his bill might gain traction in the House but, of course, the Speaker would want some substantial changes that may not fly with Chairman Grassley. 

And the states? The gridlock in Washington all but assures Congress will not pass comprehensive drug pricing legislation in the short-term—which means state legislatures will continue to be extremely active on prescription drug costs, enacting laws related to pricing and transparency, creating drug pricing review commissions and plans to import drugs, particularly from Canada. ICER-like value assessments will also play a significant role in how state Medicaid programs and other state-run drug programs pay for drugs.

The bottom line: While they aren’t likely to become law anytime soon, proposals in front of Congress that would import foreign price controls or allow American’s to buy medicines from abroad would stifle innovation and R&D in new cures that patients need and deserve.

We’re less than 10 months away from the election—and while, truly, anything can happen between now and then, we do have some insight into what we can expect in the coming months, thanks to BIO’s Federal Government Relations team. 

First, Congress: At this moment, we expect the breakdown in Congress to remain the same, with a Democrat-controlled House of Representatives, and a Republican-controlled Senate. 

What it means: While the Republican Senate will most likely protect our industry from the worst drug pricing proposals, we’ve got our work cut out for us—because policymakers, especially Democrats, continue to unfairly target the pharmaceutical industry in the quest to lower patients’ out-of-pocket costs. 

Second, the White House: Everyone has predictions, but of course, it’s harder to say for sure after how the race shook out in 2016. What’s important to note, however, is both parties continue to target the pharmaceutical industry, too—President Trump is ready to allow imports of cheap drugs, and as the field narrows, Democratic candidates are talking more and more about price controls, ranging from the most ranging from the most extreme (Sens. Warren and Sanders) to Mayor Pete Buttigieg saying he would look at patents, to Sen. Amy Klobuchar expressing support for importation. 

And what about biofuels? Many of the Democratic candidates have been outspoken in their support for biofuels and the Renewable Fuel Standard, says Agri-Pulse. Expect low-carbon fuel initiatives to remain a hot topic this year.

What’s ahead: We’ll be keeping an eye on a few key dates in the coming months.

• February 3: The Iowa Caucus, where we may get a better idea of the potential nominee, but no guarantees.
• February 4: The State of the Union, where President Trump will outline his priorities for the year. Listen for news on drug imports in particular.
• February 11: The New Hampshire Primary
• March 3: Super Tuesday, where, hopefully, the real frontrunner will begin to emerge. 

What to get involved on Capitol Hill? Join us on March 31-April 1 for the BIO Legislative Day Fly-In in Washington, D.C., where we’ll have legislative briefings and chances for you to engage with Members of Congress and tell your story.