W.ASSINGTON — President Biden, in his own words, is at stake for his own best-of-breed healthcare achievements, which he calls BFD.
After 20 years, Democrats are finally on track to break the firewall between the pharmaceutical industry and the Medicare program. Soon, the US government, like many other high-income governments, will be able to use its full influence to negotiate discounts from pharmaceutical companies.
Biden’s victory is due to the tenacious dedication of Senate Majority Leader Chuck Schumer and House Speaker Nancy Pelosi. Schumer’s final victory came on Sunday when the Senate passed a sweeping package that included climate and tax reform, in addition to a historic victory in letting Medicare handle drug negotiations. After returning to Washington, the House is expected to pass it, after which Biden can sign it into law.
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The reform is a staggering defeat for the pharmaceutical industry, which has invested staggering amounts of money to get its way in Washington and last month launched a seven-figure campaign to stop the effort. Allowing Medicare to negotiate drug prices has been the sector’s third choice for 20 years. While drug companies’ clout has undermined this proposal, even the goodwill they earned after developing a highly effective vaccine to treat Covid-19 isn’t enough to stop it. was.
Implementing Medicare’s new bargaining power would be a controversial experiment. We have time that we can use to try to bend the process to our will. It is still unclear how the new policy will change the complex dynamics of investor decision-making, drug company calculations and the generic drug outlook. So is how policymakers will tackle the patients that packages leave behind in the future.
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But for some adults over the age of 65 who take expensive medicines, a policy that limits their annual out-of-pocket costs to $2,000 would be life-changing. And progressives who want additional steps see victory in the cracking open of the door to more aggressive reform.
“For seniors who have faced the humiliation of rationing medicines or skipping them altogether, this bill is for you,” Schumer declared on the Senate floor after passage of the bill.
D.Carpet pricing reform, a 20-year historic victory for Democrats and drug pricing reform supporters, may have come untimely.
President Clinton’s failed pharmacy benefit proposal in Medicare would have given the government mandatory discounts. and gave up his own ambitions in this field. Even President Trump has been raving about drug prices for years without doing anything to bring them down.
Now the Democrats have a big political win to campaign ahead of the midterm elections. Senators on the floor Sunday afternoon patted each other on the back, hugged and shook hands after more than a year of intense negotiations.
The reforms are largely restricted to adults over the age of 65, so they won’t affect all voters. A House rules judge ruled that two provisions that Democrats wanted to include, controlling the cost of medicines for people who take out insurance through work, were not complied with. to Senate rules. Medicare also has limited ways to negotiate drugs. The first year only applies to 10 expensive drugs that have been on the market for several years and have no competitors.
Despite all the work being done towards drug pricing reform — it was so popular, it saved the federal government so much money, and Democrats had been pledging action for years. — The road to Senate approval was rocky, with multiple bills close-by-death encounters after moderate insurrection and lobbying by the pharmaceutical industry.
The package is also a win for patient advocates who have been dramatically spent by pharmaceutical companies and have watched reform bill after reform bill fade away over the years. , did not have as much effect as the progressives had hoped, but they ultimately decided that something is better than nothing.
“Without a doubt, this law is a game-changer.” It shows the transition of
The change will have the biggest impact on seniors paying for expensive medicines, which will limit out-of-pocket costs to $2,000 a year. Now, there are no limits, and in 2019 he had 1.2 million adults over the age of 65 paying more than $2,000 a year, according to an analysis by the Kaiser Family Foundation. A study published in Health Affairs in April found that Medicare adults are 39% more likely to get new prescriptions for expensive drugs used to treat cancer, hepatitis C, immune system disorders, and high cholesterol. did not respond.
AARP, which challenged the pharmaceutical industry and advocated aggressive drug pricing reform at a crucial time, hailed the passage of the package as “historic.”
“We have been working for nearly 20 years to help Medicare negotiate the price it pays for medicines,” said Jo Ann Jenkins, CEO of AARP. It will save us $100 billion and give seniors peace of mind knowing there is an annual limit on their out-of-pocket drug costs.”
D.But rugmakers aren’t celebrating.
“Today’s vote may seem like a political victory for the Democrats, but it is truly a tragic loss for patients,” said PhRMA CEO Steve Uble.
The Democratic reform is a scathing rebuke to the pharmaceutical industry accustomed to winning in Washington. The industry has a barbaric lobbying campaign, sophisticated campaign finance strategies, and a broad network of contract lobbyists and affiliated groups willing to bid that rivals few other groups.
Even last-minute lobbying wasn’t enough to stop the package from moving forward. Pharmaceutical companies started buying his 7-figure ad, put executives in the Capitol, and pumped campaign money into pharmaceutical-friendly senators, but eventually the Democrats put together a caucus .
The pharmaceutical industry argues that the negotiation process has boundaries, that the process should be like pricing, that it does nothing to help private insurance patients, and that it does not address the role of middlemen in price dynamics. I’m here.
“Unfortunately, the final-passage bill lacks provisions to systematically and holistically address the largest driver of out-of-pocket costs in our system,” said Brand Biological Lobby BIO. President and CEO Michelle McMurry-Heath said.
Not all companies will be equally affected by the policies of the Democratic reform package, and it’s also unclear exactly which drug Medicare will choose to negotiate first. Medicines manufactured by GSK, Eli Lilly and Novo Nordisk were highlighted as potential candidates for the first year of negotiations, with 10 medicines to be selected.
In recent weeks, pharmaceutical companies have been sounding the alarm to investors in unusual ways. Companies such as Eli Lilly, Pfizer, Johnson & Johnson, Bristol-Myers Squibb, and AstraZeneca, among others, said Medicare’s bargaining policy, in particular, will change how investors deploy capital and drive innovation in some disease areas. I’m telling investors that I’m going to lose.
Manufacturers of generics and biosimilars also fear that the negotiation process will replace the functionality of generics and biosimilars, discouraging investment due to uncertainty over which drugs negotiated prices. . Congressional budget analysts have not estimated the bill’s impact on the generics market. Access to generic medicines is important for patients who don’t have Medicare and can’t access negotiated prices, said Dan Leonard, president and CEO of the Association for Accessible Medicines.
Ipsita Smolinski, founder and managing director of consulting firm Capitol Street, said Medicare’s bargaining clauses are driving changes in how companies invest their research dollars, and mergers are encouraged if companies want to diversify their portfolios. He said it could be encouraged.
“It felt like it took a while for the market to realize that it was going to have an impact,” said Smolinski.
N.Or the battle is completely over. The PhRMA chairman said Ubl last week issued a bald threat that the industry could sue to block the law, arguing that Democrats who support the bill will pay politically.
The battle over which treatment to choose has also fueled a regulatory lobbying frenzy that will force drug companies to bend policy at will by 2026.
A lot can change in three years, including the administration of Congress and the White House. Democrats have tweaked the bill so that administrations that are less enthusiastic about negotiating have to push policy forward, but regulators have the flexibility to interpret the law in their own way.
Just as pharmaceutical companies have found ways to use patents to avoid competition, they may also find ways to avoid the negotiation process.
According to an analysis by Umer Raffat, senior managing director of Evercore ISI, branded pharma companies can reach settlement agreements that limit the amount of competitors to avoid the negotiation process. Congressional budget analysts also expect the launch price to be higher than otherwise. This is a strategy that allows pharmaceutical companies to make more profit in the first few years of a new drug’s launch, compensating for lower earnings later on.
It will be years before patients see Medicare negotiated prices, but the regulatory process will begin soon after the House passes the bill. Drug companies will be punished if he raises drug prices for dispensing pharmacies from October, and rulemaking on other provisions will be a huge undertaking. Medicare and Medicaid chief Chiquita Brooks-Lashua said her agency is ready to implement the bill when it is enacted.
“For too long Medicare has been forced to battle Big Pharma with one hand tied behind its back.
