Trump’s plan on pharmaceuticals needs support

I support President Trump’s recently signed four pharmaceutical-related executive orders, especially his initiative to tie the Medicare Part B price of drugs to the lowest price received by other nations (“most favored nations” pricing). While it can be argued that his actions are political, they are still welcome.

It should be noted that there’s still an “out” for Big Pharma, if it can present an alternative plan to lower drug costs by Aug. 25. Further, due to the usual D.C. bureaucracy, rule-making will not be completed during Trump’s current term, so how the change is implemented will depend on who wins the November presidential election.

I was an executive with for-profit health care group purchasing organizations for 17 years, trying to bring down drug prices for some of our largest nation’s hospital chains. We did so relative to what they could do on their own, but our pricing was still much higher than in other nations. I confirmed this fact when I conducted comprehensive pricing studies with three western Canadian provinces, which had much better pricing. although their combined drug purchasing volume was a small fraction of ours.

Trump’s most significant executive order launches what is called in the health care industry “most favored nations” pricing for Medicare Part B drugs. We should all support his efforts and ask that the initiative be expanded by Congress to cover all drugs bought by Americans. It makes absolutely no sense for U.S. citizens to pay excessively high pharmaceutical prices in order to support drug research that will benefit the entire world — including developed nations that have low drug prices.

Trump’s other three executive orders are directed toward enabling state importation of less expensive drugs from Canada and elsewhere; requiring government-funded health clinics to pass discounts on insulin and EpiPens directly to consumers; and eliminating drug discounts obtained by pharmacy benefit managers but not passed on to consumers.


Let’s see if Congress and Trump can get together on a rare bipartisan basis.

Already, there is dissension in Trump’s own party, with Republican senators and congressmen saying his orders are anti-free market. What they fail to acknowledge is there is currently no “free market” for prescription drugs. The market is heavily controlled by the government in every developed nation, including the United States. That’s why we have an FDA.

The Democratic-led House passed legislation last year that simply would have permitted Medicare to negotiate drug pricing, but that died in the GOP-controlled Senate. At the time, my own congressman and a Big Pharma group (Stop Medicare Takeover) sent out a mailer calling the House plan “radical,” “socialism,” “drug rationing” “and price fixing” and that it would result somehow in “withholding medicine from the sickest patients.” None of these assertions has any basis in fact, nor were they explained in the mailer.

If House Speaker Nancy Pelosi (D-Calif.) is wise, she will quickly push legislation through the House endorsing Trump’s approach word for word. That would put Senate Majority Leader Mitch McConnell (R-Ky.) on the spot, forcing him to pass the Trump initiative or appear to be caving to drug company lobbyists. (Note: Both parties rely on these lobbyists’ campaign contributions, which are substantial.)

If such legislation were to pass both the House and Senate, that would be putting the American people first. However, based on past experience, I sincerely doubt such a thing will occur. My bet is that the lobbyists will win the pharmaceutical battle, unless there is a lot more public pressure than we are currently seeing.

In 2016 Trump said that, “We can increase [prescription] competition and bidding wars, big time.” Yes, undoubtedly. However, we must have a truly committed president and a Congress (Democrats and Republicans) that is not swayed by Big Pharma campaign contributions.

Jack Bernard, former Georgia Director of Health Planning, is a retired senior vice president with a national health care corporation and a Fayette County Board of Health member.