The Senate Finance Committee's version of #summervibes
If the Senate Finance Committee’s goal for Summer ‘19 was to “stay relevant,” they’re certainly making some good progress. On Tuesday, the Committee approved a broad bipartisan proposal aimed at lowering prescription drug prices.
What’s in the bill?
- Redesign Medicare Part D to cap out of pocket costs and shift more catastrophic costs to pharma companies and health plans.
- Cap Medicare Part B and Part D drug prices at inflation. Note: this pertains to price increases but cannot restrict prices at launch.
- Ban PBM “spread pricing” practices in Medicaid, where PBMs keep the difference between a pharmacy price and the wholesale price.
- Require drugmakers to justify increases at certain price points.
- Allow state Medicaid to use risk-sharing agreements to finance gene therapy treatments through installment payments.
What’s not in the bill?
- International Pricing Index (IPI) language: Senators voted down an amendment to prohibit implementation of this proposed rule, but only because Committee Chairman Chuck Grassley wanted to keep the issue separate from the broader bill.
- Allowing Medicare to negotiate directly with drug makers: Senators voted down an amendment to include this controversial language, but it could always be added later on the Senate floor.
So everyone just agreed on this?
Not really. During the bill markup, Senators debated high drug prices, which some deemed as “monopolistic.” The most debated topic – brought up by several Republicans who oppose the inflation cap – was around whether capping price increases at inflation would incentivize higher prices at launch.
Senators even discussed reviving some of the administration’s failed proposed rules, like the rebate rule that would have ended rebates pharma companies pay to PBMs under Medicare, and the rule requiring price disclosure in pharma’s direct-to-consumer advertising.
Meanwhile, PhRMA, which strongly opposes the bill, had the chance to tell President Trump as much during a private meeting on Wednesday.
What happens next:
The Trump administration supports the bill, but congressional prospects are unclear. Committee leaders intend to merge this bill with separate surprise medical billing legislation that the Senate HELP Committee cleared last month, and then will determine a potential vote by the full Senate.
P.S. Have we mentioned yet that the House is working on their own totally separate bill?
Who wrote this? The managing editors of TWTW are Dana Davis, who wishes the LIRR would take a page out of Amtrak’s book and Randi Kahn, who forgot to bring jeans to a weekend trip in the mountains (brrr).
Syneos Health Communications' Reputation & Risk Management Practice is a team of healthcare communications consultants, policy-shapers and crisis response specialists. We provide unique solutions to the evolving communications challenges in today’s healthcare industry, using evidence-based approaches to help our clients successfully navigate the most sensitive of situations.
Got thoughts? Contact Dana
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