The drug industry’s main lobbying arm has proposed limiting how much drug middlemen can pocket for selling medicines, a position it is calling a “bold new stance.”
The middlemen, known as pharmacy benefit managers, have taken heat from the Trump administration for their purported role in high prices that patients pay for medications. Pharmacy benefit managers negotiate drug prices for health insurance companies, but have been accused of not passing on savings from rebates to patients.
The Pharmaceutical Research and Manufacturers of America, or PhRMA, has proposed in public comments that these groups receive a flat fee for the share of negotiating and selling a drug, rather than a share of the list price.
The latest position was included in public comments posted about the Trump administration’s blueprint to lower drug prices for patients.
Members of the public were invited to comment up until Monday on the blueprint, which includes several proposals to revamp Medicare Part D, a program covering prescription drugs for seniors. The idea would prompt pharmacy benefit managers and insurers to share with consumers more of the rebates they get from drugmakers.
The Pharmaceutical Care Management Association, which represents the pharmacy benefits managers, disputes that it is responsible for the high costs patients pay for drugs and said in its public comments that policies shouldn’t undermine their ability to negotiate rebates. The ideas in the blueprint failed “to address the root cause of rising drug costs: high list prices,” the group wrote.
Several groups representing patients weighed in on various parts of the proposal. The American Cancer Society Cancer Action Network recommended allowing people on Medicare to use copay discount cards when generics or biosimilar drugs are unavailable and letting pharmacists tell patients about how they can get medicines at a lower cost.
The Council for Affordable Health Coverage backed a proposal to allow government programs such as Medicare to pay for the type of value that drugs bring to patients, meaning how effective they are, and 40 left-leaning consumer groups, including Families USA, said that the federal government should directly negotiate drug prices.
Health officials have signaled they will not be pushing this approach; Health and Human Services Secretary Alex Azar has pointed to estimates from the nonpartisan Congressional Budget Office that direct negotiation won’t generate any new savings.
They have instead advocated for targeting in new trade agreements the low prices that other countries pay for U.S.-manufactured drugs.
Other countries, especially Canada and European countries, pay less for pharmaceuticals than U.S. consumers do because of negotiating power by their government-run, single-payer healthcare systems.
PhRMA said it supported “preventing other countries from free riding off U.S. innovation” and said that price limits set on drugs in other countries was a “harmful” practice that gets in the way of research and developing new drugs.
