Publicado: Lun, Octubre 29, 2018
Salud | Por Gertrudes Rodriquez

Pres. Trump focusing on drug prices, high among voters' concerns

Pres. Trump focusing on drug prices, high among voters' concerns

Despite Medicare being one of the world's largest drug purchasers, prices in the USA were 1.8 times higher compared to the other economies.

"For decades, other countries have rigged the system so that American patients are charged much more", President Trump said Thursday in a speech at the U.S. Department of Health and Human Services, which administers Medicare.

President Donald Trump introduced a plan to allow Medicare to pay lower drug prices for Part B coverage.

Azar, a former executive at the pharmaceutical giant Eli Lilly, said his agency compared prices for the most costly drugs covered by Medicare insurance that are administered by physicians.

HHS Secretary Azar tweeted that "Medicare was found to be paying the highest price for 19 out of the 27 drugs studied compared to these other countries".

Creating an index of prices tabulated from what countries with more centralized health coverage pay would allow the administration to drive down US drug costs without putting in place direct curbs on prices - though Azar rejected the idea that the administration was reading from the playbook of nationalized medical programs to bring the USA on par with the rest of the world. During his speech, Trump cited an example of a "common" cancer drug that he says is seven times more expensive for Americans than for those living outside the United States, though he didn't name the drug specifically.

The high prices resulted in Medicare and its beneficiaries "bearing unnecessary, potentially avoidable costs for Part B drugs", CMS stated in a fact sheet on the IPI payment model. But basing Medicare reimbursement on what other countries pay would be a huge departure from how the program now works - and run counter to Republicans' allegiance to the free market system. Medicare, which covers 55 million elderly and disabled Americans, is responsible for 29 percent of the nation's prescription drug spending. "The United States has a competitive marketplace that controls costs and provides patients with access to innovative medicines far earlier than in countries with price controls, and it's why we lead the world in drug discovery and development". "The mark-up on Part B drugs appears to independently influence prescribing patterns", said a May policy paper from Memorial Sloan Kettering Cancer Center's Drug Pricing Lab. "This happens because the government pays whatever price the drug companies set without any negotiation whatsoever".

In tweets Thursday morning, HHS Secretary Alex Azar referred to Trump's criticisms of other governments that pay significantly less for drugs than does the USA government.

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The Trump administration is no longer reimbursing for individual payments on the basis of the price of the drug. "There is more coming". "President Trump asked us to fix this problem and here's how we plan to do it". In the five-year experiment, carried out through CMS's innovation center, prices will be gradually and increasingly pegged to the new global index instead of average USA sales price. The IPI model instead would engage private sector vendors to offer certain drugs to participating physicians and hospitals at a rate based on a Target Price derived from an worldwide price index. It could also lower some of seniors' out-of-pocket costs, which are based on the total price paid by Medicare for a given drug.

Already, however, there is skepticism about how much this will impact the drug industry. Most of the drugs in the Part B plan are a kind of drug called a "biologic", or drugs made of living organisms (usually cells). "This is very much about putting America first".

The proposed changes are related to the Medicare Part B program that pays for medications that patients receive in hospitals or in doctor's offices.

The HHS study, for example, shows that the USA spent about $1.7 billion in 2016 on Rituxan, a drug made by Biogen Inc. that treats non-Hodgkin's lymphoma.

House Minority Leader Nancy Pelosi of California said if Trump wants to save seniors money he should seek congressional approval for Medicare to negotiate prices for its main prescription drug program, "Part D". In a March Kaiser Family Foundation poll, eight in 10 respondents said drug costs are unreasonable and 92 percent said passing legislation to bring down the cost of prescription drugs should be a top or important priority. This is not a change for industry or for companies or for pharma.

The president in May also claimed drug companies would be announcing "massive" voluntary price cuts.

The administration has moved twice this month to lower drug prices in other ways.

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