Throughout 2017, the issue of prescription drug costs has received much attention in the media and among policy makers.  Republicans, who had generally shied away from the conversation in the 114th Congress, have spoken up in greater numbers regarding the need to do something about the issue.  But despite this increased discussion, the big, sweeping legislative effort that many were anticipating hasn’t come to fruition and it doesn’t appear to be imminent.

Like so many other debates in Washington, President Trump has entered the fray, speaking forcefully on high drug costs and tweeting about specific companies or products, introducing a new wildcard into the usual policy mix.  Throughout his campaign and presidency he has hinted at major action on this subject; nevertheless, despite rumors of a draft Executive Order on prescription drug prices, nothing has materialized.

At the other end of Pennsylvania Avenue, the House Energy and Commerce Committee recently held a hearing on the drug supply chain, and the Senate HELP Committee has held a series of sessions on drug pricing as well, including most recently in December.  Whereas in the past Republicans had largely focused their ire towards the Food and Drug Administration as stalling innovation and competition, this year we’ve seen a growing number of Republicans criticize players up and down the supply chain.

In particular there has been increased focus on the role of pharmaceutical benefit managers and the extent to which they affect pricing for consumers – including how much they share rebates with patients or keep them to themselves and how their practices may restrain pharmacists from sharing information with patients about lower cost options to obtain drugs.

That being said, these discussions still have yet to lead to meaningful legislative action.  A line from the recent Energy and Commerce hearing largely sums up the current state of play.  Members urged life sciences companies “to get their act together” so Congress isn’t forced to step in.  So, despite much tougher talk than we’ve seen in the past, there doesn’t seem to be an appetite among Republicans to take action in the near term.

In case you missed it, WSW’s review of the most recent Energy and Commerce Committee hearing can be viewed here: E&C Drug Supply Chain Hearing 12.13.17 and the Senate HELP Committee hearing can be viewed here: Senate HELP Hearing on Drug Costs 12.12.17 

Even if 2017 did not see any major developments on the cost of prescription drugs, we are keeping close tabs on the following fronts where we may see this issue heat up again in 2018:

  • The confirmation process for Alex Azar, CEO of Eli Lilly, where the company’s pricing of insulin products has come under particular scrutiny by Senate Democrats. Azar’s nomination still needs a hearing in the Senate Finance Committee, expected in mid-late January, and to clear the full Senate.  At his hearing in the Senate HELP Committee, he said he wants to do something about drug prices.  Will he provide more specifics before the Senate Finance Committee?
  • Efforts by Rep. Elijah Cummings (D-MD), the top Democrat on the House Oversight and Government Reform Committee, to urge the Trump Administration to negotiate prices directly with drug companies. One interesting aspect of this dynamic is that at different points in 2017, Rep. Cummings has received audiences with President Trump individually to press his case on drug prices, unusual among Democrats. FDA Commissioner Scott Gottlieb has made facilitating competition in the pharmaceutical marketplace – and thus lowering prices –a priority for the agency. He’s outlined a number of steps the FDA is taking, including providing more scientific and regulatory clarity to manufacturers on how to develop complex generic drugs.

What are you hearing and what do you see on the horizon?  Please let us know at submissions@capitolvitals.com and keep the conversation going by tweeting us @capitolvitals

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Rob Zucker is a Partner at Winning Strategies Washington, a DC-based government relations firm, where he focuses on public health policy, funding and advocacy, including Substance Use Disorder treatment and other issues related to the federal response to the opioid epidemic.

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