With the $1.9 trillion American Rescue Plan in the books, Congressional lawmakers and White House officials are turning their attention elsewhere. And that could be bad news for drugmakers.
In fact, as the Biden team works through a new, $3 trillion package, lawmakers are looking at targeting drug prices as one component, The Washington Post reports. Under a potential proposal, drugmakers would have to lower certain prices or pay penalties, according to the newspaper.
Lawmakers are looking at drug price savings as one way to pay for other measures included in the package, The New York Times says. Meanwhile, reports suggest Democrats plan to score savings on pharmaceuticals to help offset newly passed expansions to the Affordable Care Act.
“For the first time in many years the threat of material changes in drug pricing are likely,” Cowen analysts Rick Weissenstein and Eric Assaraf wrote to clients this week. “The drug lobby is in the unfamiliar position of playing defense.”
In a commentary on the drug pricing landscape, the Cowen analysts said they expected an “aggressive” bill to develop in the House of Representatives, but that a “less onerous” bill would come out of the Senate. The process is complex and there are numerous political considerations at play, they cautioned, noting that the process would take months.
Under the reconciliation process, which Democrats will likely use for their bill, a key rule calls for spending to be offset by savings, the analysts wrote.
“It is this rule that makes it likely drugmakers will be targeted for savings,” they added.
The drug pricing ripples have attracted the attention of other industry analysts, who have flagged mounting risks in recent weeks. While HHS secretary Xavier Becerra’s confirmation was “widely noted,” Bernstein analyst Ronny Gal wrote in a note of his own, what’s been “less discussed” is that “the legislative effort on drug pricing is likely to start on the early side.” The fact that Democrats seem to be prioritizing the issue represents a “negative” for the industry, Gal wrote.
For his part, SVB Leerink analyst Geoffrey Porges said that stricter stances from the FTC and FDA on M&A and drug reviews, respectively, could combine with drug pricing legislation to create a tougher environment for the industry. The “long-term reality” for the industry “seems certain to feature more restrictions on drug pricing,” Porges wrote.
It’s not yet clear which avenues lawmakers or White House officials will pursue to lower drug prices. In a February status report, Kaiser Family Foundation experts laid out potential approaches to tackling high drug prices such as the “most favored nation” pricing initiative pursued by the Trump administration, Medicare pricing negotiations, importation and more.
In an interview, one of the authors, Juliette Cubanski, said the current landscape in Washington seems to represent a “perfect storm” for action on the issue. Biden campaigned on lowering prices, while Democrats in control of Congress are in favor and there’s “a lot of enthusiasm” among the public for action, she noted.
Still, it remains to be seen exactly where lawmakers can find common ground, said Cubanski, who serves as KFF’s Deputy Director of the Program on Medicare Policy.
The discussions are “still evolving,” she said, but “now that it seems immediate attention on the COVID stimulus bill has passed,” officials have “breathing room” to focus on other priorities. It’s “not too surprising” to see talk around drug pricing resurface, she said.