WASHINGTON President Biden on Thursday took his most concrete action to date regarding prescription drug prices and called on Congress to adopt a series of long-term reforms that include allowing direct price negotiations within Medicare and limiting deductibles to the elderly.
In the shadow of twinkling chandeliers, Biden leaned forward to make a unique, personal appeal from her bullying chair – spoke honestly about her mother, Catherine Finnegan Biden, and the expensive drugs she needed towards the end of her life.
The announcement puts an end to months of speculation about how aggressively the administration plans to pursue major reforms of the pharmaceutical industry, even though it is working closely with drug manufacturers to manufacture and distribute Covid-19 vaccines.
“We can distinguish between developing these breakthroughs and raising the prices of a range of drugs for a range of everyday diseases and conditions,” Biden said.
A new document, the White House unveiled on Thursday, describes its most detailed platform yet – though the document now does not contain any new ideas for reforming the way Americans pay for medicine. Instead, it contains a number of policies that Congress Democrats, presidential candidates in 2020 and Biden himself have previously approved.
In particular, during his remarks, Biden specifically approved a controversial provision in House Speaker Nancy Pelosi’s drug pricing legislation that would impose a large tax on drug manufacturers’ revenues if they stopped negotiations with Medicare.
“[Medicare negotiation] means that pharmaceutical companies will have to sell their medicines to all distributors at the Medicare price or pay a 95% excise duty, ”said Biden.
However, he said that negotiated prices should still lead to a “significant profit” for drug manufacturers.
This comment did not allay drug manufacturers’ concerns about Biden’s policy proposal, as the brand-drug lobby PhRMA claimed that its Medicare negotiation policy would undermine access to medicine.
Although Biden is an ardent advocate of accelerating the development of treatments for diseases such as cancer – a hunt that the pharmaceutical industry had hoped to exploit – he insisted that innovation could still continue after the reform.
In typical Biden fashion, he told a story to make his point. As he led a lunar eclipse to cure cancer as vice president of the Obama White House, drugmakers told him that if they developed a cure for cancer, they would be able to charge “whatever the market would carry.”
“This means that a significant number of people cannot afford it and they will die without it. That is unacceptable, ”said Biden.
Biden also remembered up until his mother’s death when he and his siblings had to line up to cover thousands of dollars monthly costs for her prescription medication.
While Biden struck a firmer tone and offered more detail than he has before, his proposal still did not go as far as some progressives would have wished.
Compared to his many years of calls to allow Medicare negotiation, Biden’s proposal is limited. This seems to apply only to medicines that do not face generic competition. These are probably the drugs that account for the majority of government and patient spending, but possibly a smaller list than previous proposals from progressive lawmakers. Some previous bills have called for allowing Medicare to negotiate the price of between 50 and 250 drugs; others would simply allow the program to negotiate prices for each medication it covers.
In addition to limiting the out-of-pocket costs of the elderly, the proposal calls for drug companies that raise prices faster than inflation to be penalized, allowing states to import lower-cost drugs from Canada and increase the uptake of generic drugs and so-called biosimilars.
The Biden administration also ruled out a number of policies that progressive Democrats have long preferred – namely to use the intellectual property rights of pharmaceutical companies as leverage in price negotiations.
The plan also briefly stops using an international reference as a benchmark for pricing. The document provides little specific information about the “framework” that should guide Medicare negotiations, and omits the tactics that President Trump, Senator Bernie Sanders (I-Vt.) And House Speaker Nancy Pelosi have each approved: by using foreign prices as a cap for drugs in the United States.
This story has been updated with Biden’s remarks from a Thursday speech.
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