Reporting on legislation to lower prescription drug prices has been like riding a seesaw. One week, things look good and the next week it all falls apart.
The latest news is that Senate Democrats seem to finally have the votes they need to pass the bill to lower drug prices but there are more hurdles they must cross before they get there.
As has been the case from the beginning of the Biden administration and the evenly split Senate, Republicans and the powerful pharmaceutical industry are fiercely opposed to any bill that lowers drug prices. Add to that the resistance of Senator Joe Manchin (D-W.Va.) and one or two other Democratic Senators to the various pieces of legislation that have contained provisions to lower prices, and we have been on a roller coaster ride for months in the effort to pass the needed legislation.
However, it appears we may finally be closing in on a bill that can pass. The new bill would allow Medicare to negotiate lower prices for 10 drugs per year starting in 2026 and 20 starting in 2029.
Under that deal, Medicare negotiation can only apply after a drug has been on the market for a certain period of time: nine years for many drugs and 13 years for complex “biologic” drugs.
The bill would impose a steep tax of up to 95 percent on drug companies that refused to come to the table and would also impose a ceiling that the negotiated price could not rise above, features that critics have used to argue that the bill is really just “price controls” rather than “negotiation.”
Other provisions would prevent drug companies from raising prices faster than the rate of inflation beginning this year and cap out-of-pocket drug costs for seniors on Medicare at $2,000 per year starting in 2025.
The Congressional Budget Office (CBO) finds the drug pricing provisions would save about $288 billion over 10 years while extending the increased ACA subsidies for two years would cost about $40 billion.
Republicans are opposed to the bill for the same reasons they have stated all along, including that it is “socialism” and the claim that it would result in less innovation and fewer new cures. This is the same excuse being pushed by the drug companies.
The Congressional Budget Office (CBO) has evaluated the bill and estimated that there would be a modest reduction in new drugs being developed: perhaps 15 fewer drugs out of 1,300 expected to be approved over the next 30 years.
So, the fact remains that with a razor-thin margin in a 50-50 Senate, the absence of any Democratic senators due to COVID-19 or other reasons could throw off the party’s plans.
With the news today that Senator Manchin has Covid-19, the uncertainty of passing the bill has been amplified. Add to that the fact that Sen. Patrick Leahy (D-Vt.) still has not returned to the Senate after a hip replacement surgery, it means Democrats are currently down at least two needed votes to pass the drug bill. That makes it all but certain the legislation will not pass this week and unclear if it will be able to pass prior to the Senate leaving town for the August recess in two weeks.