Because of unanimous Republican opposition to any current legislation being considered to lower prescription drug prices, all eyes are on the Democrats in both the House and the Senate. In particular, the two Senators receiving the most attention are Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.).
According to a report in Politico, last week Sinema “told the White House that she’s opposed to the drug pricing proposals drafted by House Democrats, which could raise hundreds of billions of dollars to help finance Biden’s party-line bill. A number of House moderates — most of whom have received substantial donations from the pharmaceutical industry and represent districts where drug companies employ thousands of people — also say they’re concerned about the bill’s impact on the development of new cures and therapies, echoing arguments the industry itself is pushing in ad campaigns.”
Manchin has expressed support for drug pricing reform, but he has repeatedly said he’ll only accept a price tag of $1.5 trillion for the bill, or $2 trillion less than the figure House and Senate Democrats have worked with for months.
Many lawmakers say they’re confident they can still find a middle ground between the legislation favored by progressives that would empower Medicare to bargain directly with drug companies, and the version pushed by House centrists that would negotiate lower prices for a far narrower set of drugs. The members argue a watered-down drug negotiation bill may be the best they can hope for given Democrats’ narrow voting margins and an onslaught of opposition from the pharmaceutical industry.
And with just a few weeks left to come to an agreement, the list of unresolved questions around the bill remains long. How many and what kind of drugs will be subject to negotiation? Will the government use an international or domestic benchmark for those negotiations, and how will they penalize drug companies that refuse to comply? How much can the government claw back from companies that raise their prices faster than inflation?