Last year, Donald Trump charged the pharmaceutical industry with “getting away with murder” for its profiteering off of Americans’ prescription drugs. Now that he’s released his “blueprint” for dealing with drug prices, it looks like he’s in on the deal.
Wall Street was quick to cheer the Trump blueprint, unveiled on May 11. Right after it was announced, prices on pharmaceutical stocks soared. And even though Trump had promised to go after pharmacy benefit managers—middlemen between drug-maker and insurers who take a cut of the industry’s profits—his policy prescriptions spared them, and their stock prices soared too.
Right after Trump announced his drug “blueprint,” prices on pharmaceutical stocks soared.
Drug makers and industry middlemen had many reasons to breathe easy after Trump’s speech. First, he broke his promise to use Medicare’s massive purchasing power to directly negotiate lower drug prices, as the United Kingdom does with its National Health Service.
Instead, Trump used a variety of weasel words to preface ideas that might lower drug costs. He said he would, “evaluate,” “streamline,” “examine,” and so on. Nearly half of his proposals came under the heading “seeks feedback,” meaning he might yet give the industry a pass with those ideas.
One idea under the “seeks feedback” heading was more about cutting health care to the poor than drug prices. Trump called for further cuts in federal dollars to safety net hospitals, based on a false claim that this would lower drug costs. And he would lower drug co-pays for some Medicare recipients, which would amount to robbing Peter to pay Paul, as the lower co-pays would be made up by higher premiums.
Finally, Trump finished his speech by acknowledging that “medicine that costs a few dollars in a foreign country costs hundreds of dollars in America for the same pill, with the same ingredients, in the same package, made in the same plant.” But what’s his plan to alleviate this asymmetry? “I have directed [a U.S. Trade Representative] to make fixing this injustice a top priority with every trading partner . . . America will not be cheated any longer, and especially will not be cheated by foreign countries.” It’s a claim just as ridiculous as saying Mexico would pay for a border wall.
Trump’s speech was in perfect accord with the pharmaceutical industry power brokers he’s brought into his administration.
Alex Azar, his new Secretary of Health and Human Services who stood by him when he presented his blueprint, last worked as president of the U.S. division of pharmaceuticals giant Eli Lilly & Co. Trump’s Food and Drug Administration chief, Scott Gottlieb, was a longtime industry investor and adviser to major drug-makers like GlaxoSmithKline and Bristol-Myers Squibb. And his administration hired a lobbyist from Gilead, a leader in specialty drug profiteering, and one from McKesson, a wholesaler that admitted to selling opioids to potential pill mills across the United States.
The high drug prices these hires are protecting directly endanger the lives of many Americans. Already, a quarter of Americans say they or a family member have not filled a prescription, cut pills in half, or skipped doses due to cost. People with cancer are skipping drugs and dying sooner because of high drug costs.
Thanks to Trump’s “blueprint,” more Americans may die sooner because of high drug costs.
The high drug prices directly endanger the lives of many Americans.
The danger is magnified by the boom in so-called specialty drugs that are used to fight cancer or deal with difficult conditions like multiple sclerosis, but that cost tens, if not hundreds, of thousands of dollars. While these drugs accounted for less than one-third of total prescription drug spending in 2014, they are expected to represent almost 50 percent of drug sales by 2020. Between forty and fifty new specialty drugs are set to hit the market each year for the next five years.
Rising specialty drug costs could threaten the affordability of all health care. That’s because as insurance plans absorb specialty drug costs, many insurers will hike out-of-pocket costs, shifting the cost to the patient and provider. Those higher out-of-pocket hikes will keep some Americans from getting medical care they need when they’re sick or injured.
Trump’s drug price blueprint leaves drug prices rising and the number of people getting needed medicines and health care falling. It leaves more Americans getting sick and more dying too young. He’s letting drug-makers get away with murder.
Ramón Castellblanch is a Professor Emeritus of Health Education at San Francisco State.