Negotiating drug prices under the Medicare program.
Allowing more medications to be imported from other countries.
Speeding up the drug approval process.
Those are the basic tenets of President Donald Trump’s plan to reduce prescription drug prices in the United States.
The president reiterated some of those positions as well as unveiling a proposal to “streamline” the Food and Drug Administration (FDA) when he met Tuesday morning with pharmaceutical executives and lobbyists.
Trump took a more conciliatory tone with the pharmaceutical leaders than he did a couple weeks ago when he accused the industry of “getting away with murder.”
After today’s meeting, both sides said they would work together to try to make drugs more affordable for consumers.
For that to happen, there are two big questions facing the White House.
One is will Congress approve the president’s plans.
The second is will the plans work.
What the president proposes
During the 2016 presidential campaign, Trump advocated a plan to allow officials in the Medicare health program to negotiate drug prices with the pharmaceutical industry.
Current U.S. law prohibits such talks. Other countries, including Canada, France, and the United Kingdom, allow government officials to negotiate drug prices. Some experts say that has kept prescription prices down in those countries.
Medicare covers more than 55 million older Americans. The Medicare and Medicaid systems spent $325 billion on prescription medicine in 2015.
Trump mentioned this proposal again during Tuesday’s meeting.
Kurt Mosley, vice president of strategic alliances for Merritt Hawkins consultants, said this strategy could be an effective one.
“It could bring pharmaceutical companies back to the table,” he told Healthline.
During the campaign, Trump also floated a plan to make it easier to import prescription drugs from other countries.
He said this would increase competition and lower drug prices.
The president didn’t mention this plan specifically during Tuesday’s meeting, but he expressed interest in global trade and tax policy that he said could benefit U.S. drug manufacturers.
“We’re gonna be changing a lot of the rules. We’re going to be ending global freeloading,” Trump was quoted as saying by Politico. “Foreign price controls reduce the resources of American drug companies to finance drug and R&D innovation.”
At least one critic said the president had caved in to the pharmaceutical industry by backing off price negotiations and instead promising less regulation and lower taxes.
Others were more optimistic.
After the meeting, The Campaign for Sustainable Rx Pricing (CSRxP) applauded the president’s focus on reducing drug prices.
Rodney Whitlock, vice president of health policy at ML Strategies, and a consultant to CSRxP, told Healthline this week that changes such as the Medicare negotiations and the import rules could have an impact.
“The ones on the table are very significant steps,” Whitlock said.
On Tuesday, the president also discussed an overhaul of the FDA drug approval process.
He said he’ll be naming an FDA commissioner soon who will streamline the agency.
Trump also expressed an interest in possibly allowing some drugs to be approved before they’ve been proven safe, according to Politico.
“We're gonna be getting rid of regulations that are unnecessary, big league,” the president said.
Mosley told Healthline last week that quicker approvals, especially for generic drugs, could boost the free market.
“The president can do a lot of things,” he said.
What else can be done
Whitlock said CSRxP would like to see the president and Congress go even further.
His organization calls for transparency, competition, and value in the pharmaceutical industry.
Whitlock said one of the key ways to boost transparency is for drug companies to disclose how much they have spent on research and development for specific medications.
He said that would let the public know when these companies have recouped their costs on drug development.
“It could produce some self-moderating of prices,” Whitlock said. “We want to try to create market-based solutions.”
Another tactic CSRxP is pushing involves hearings later this year on user fees the pharmaceutical company pays the FDA to review their drugs.
Whitlock said Congress could use this reauthorization as leverage to force the pharmaceutical industry to make changes.
Officials at the Pharmaceutical Research and Manufacturers of America (PhRMA) think the solutions lie in ensuring patients have access to medications and instituting more “patient-centered care.”
In an email to Healthline, officials at PhRMA noted their industry spends more than $70 billion a year in research and development of drugs.
“Breakthrough medicines are revolutionizing how we treat disease, saving patient lives, reducing healthcare costs, and improving public health,” the statement read. “Today, medicines are purchased in a competitive marketplace where large, sophisticated purchasers aggressively negotiate lower prices.”
The industry association said it intends to work with the federal government in the coming years.
“We look forward to working with the administration and Congress to advance proactive, practical solutions to improve the marketplace and make it more responsive to the needs of patients,” the association stated.
The organization has launched a $100 million multiyear advertising campaign called GOBOLDLY to showcase what it calls “the industry’s unsung heroes driving cutting-edge advances in science.”
However, CSRxP officials see this as nothing more than a distraction from the industry’s price gouging.
“No amount of advertising will make hardworking families forget the consequences of their out-of-control drug costs,” a statement on the group’s website says.
Whitlock added that getting changes through Congress could be difficult given that the pharmaceutical industry has one of the top three largest lobbying groups in Washington.
“It’s an uphill battle, but it’s a battle worth fighting,” he said.