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Utopia Talk / Politics / Trump VS high drug prices
Wed Jul 29 07:32:09

MON JUL 27, 2020 / 1:35 PM EDT
Explainer: Trump's plan to cut drug prices
Carl O'Donnell

FILE PHOTO: RealTime Laboratories prepares samples for the coronavirus disease (COVID-19) testing with PCR amplification in Carrollton, Texas, U.S. June 24, 2020.
(Reuters) - U.S. President Donald Trump on Friday signed four executive orders designed to reduce drug costs for consumers, in a bid to highlight his commitment to cutting prescription prices ahead of the November presidential election.

The orders, which range from relaxing drug importation rules to cutting Medicare payments to drugmakers, are far reaching but experts say they are unlikely to take effect in the near term and in some cases lack specifics.

The executive orders have for the most part been proposed by the Trump administration in various forms in the past, but stalled amid industry pushback.


Trump signed an executive order requiring that the pharmaceutical benefits managers (PBMs) that negotiate on behalf of government health plans pass the discounts they receive directly to consumers. The rule applies to Medicare Part D, a government health plan primarily for seniors. It would reverse the longstanding practice of PBMs passing a portion of savings back to the health plan itself and pocketing the remainder as profit.

The administration said the order could reduce drug costs to seniors by as much as $30 billion per year. But industry analysts say it will be difficult to implement without falling afoul of the orders' commitment to keep Medicare premiums flat.


This executive order instructs the U.S. Department of Health and Human Services (HHS) to permit individuals to import lower cost drugs from abroad. It also allows for re-importation of insulin and orders HHS to complete an ongoing effort begun in 2019 to let U.S. states import drugs from Canada.

Industry analysts have been skeptical that importation will greatly reduce drug prices, in part because there is a limited supply of drugs in foreign markets that can be diverted to the United States.


Trump ordered certain healthcare providers to sell insulin and injectable epinephrine at greatly reduced prices to patients who have no health insurance or scant coverage. Insulin and epinephrine are life-saving drugs for people with diabetes and severe allergies, respectively.

More than 30 million Americans have diabetes. The average price of insulin in the United States nearly tripled between 2002 and 2013, according to the American diabetes association. Reuters previously reported that the cost of insulin in the United States per vial was $320, while in Canada the same medication under a different name was $30.


This rule, if implemented, would require Medicare to tie the prices it pays for drugs to those paid by other countries. Specifically, it would only pay a price for a drug that matches the lowest price paid among foreign governments. Medicare is currently prohibited from negotiating the prices it pays to drugmakers.

The order, which has been discussed as a possibility by the administration for more than a year, could potentially slash Medicare payments by billions of dollars. However, Trump has delayed implementation of this proposed rule until late August to give drugmakers a chance to propose an alternative solution.

If it is implemented, the rule would likely face legal challenges from drugmakers. There could also be challenges in determining what price other countries pay, given that many negotiations between governments and drugmakers are kept confidential


Why can't we just let Medicare negotiate drug prices? Thats retarded.

You can't call it free market, its literally a legally protected and subsidized market.

I mean they literally ban you by threat of jail for getting prescriptions elsewhere, and must go through our highly traimed and paid middlemen/dealers, but then say they can charge whatever they like, because you know free market.

I'm not talking about the current changes here obviously but what has been going on.
Wed Jul 29 10:08:50
I have a friend who is an insulin user. She'll let me know if the prices comes down to pennies a day like Trump promised.
Of course Trump never said how many pennies a day it would cost.
Wed Jul 29 10:19:13
My dad uses insulin , but the his insurance covers it, if he does pay anything its like $3 or less a month.
Wed Jul 29 10:23:51
There are 7.4 million Americans with Diabetes. Of them I'm sure there are quite a few who have lost their jobs due to the Pandemic. In our wonderful society if you lose your job you are shit out of luck for insurance.
Wed Jul 29 10:48:22
Well, depends. There is cobra and most populated states offer welfare medical.

I do think we should prioritize major illnesses like Diabetes, so this is a start.
Wed Jul 29 10:57:45
"My dad uses insulin , but the his insurance covers it, if he does pay anything its like $3 or less a month."

And how much does his insurance cover? It's been a long-running tactic for drug companies to make the cost to the patient as low as possible on high-visibility drugs and make up their profits on the back end by charging insurance companies, hospitals, physician orgs on the back end where it isn't visible to the public.

Your dad may only pay $3 out of pocket a month, but how much higher are insurance premiums because of all the people only paying $3 a month while their insurance company pays orders of magnitude more and charges everyone else?
Wed Jul 29 11:06:04
Hood, Oh definitely, I didn't mean to say otherwise. Only to say I dont know the real costs. I think henpays about 200/ month for insurance but the real costs of a lot of things like you said are less visible.
the wanderer
Wed Jul 29 12:02:18
for the record, this is how Trump represented his executive orders:

Yesterday I signed four measures that will massively reduce the prices of prescription drugs, in many cases by more than 50%. Nothing like this has ever been done before because Big Pharma, with its vast power, would not let it happen. Expensive Insulin went from big dollars.....

...to virtual pennies. Epi-pens went from their incredibly high, jacked up prices, to lower than their original give away bargains. Biggest price reductions in history, by far! Nothing like this has ever for our citizens, especially our Seniors. REMEMBER YOUR FAVORITE PRESIDENT!

not that he has ever represented any executive order accurately, nor ever not exaggerated his alleged accomplishments
Wed Jul 29 12:14:11
Meh, thats Trump. I imagine je describes his Bm as the greatest Bm in history, absolutely a perfect shit.
Wed Jul 29 13:57:44
I guess we'll have to wait and see if real costs actually come down at any great reduction. Or will it be like the department store sales of old. The ones where they just went and changed the sale tags to read reduced from a much higher price. The sale price being the same as it was the day before.
Wed Jul 29 18:03:04
"Why can't we just let Medicare negotiate drug prices? Thats retarded."

Because of the tendency for companies to abuse the system and politicians being more than willing to allow the abuses to happen.
Under Medicare you can get a little four wheel scooter to ride if you have problems walking. You can't buy the scooter, you rent it. The monthly rent is more in three months of rental then buying the scooter would be. People have those scooters for years with the government paying rent the entire time.

Back to pharmacies, they know Medicare has to provide those drugs. There is no real incentive for the companies to reduce prices any more than they are forced to by law.
Same thing happened with insurance when all of a sudden it was required and if you couldn't afford it the government would make up the difference. My insurance went from $283 a month to $854 a month within 18 months of the change. My part was just around $250 a month so if I was an idiot like most the front range here in Colorado I would think great insurance costs less. Not being an idiot I know somebody somewhere is paying that extra $600.
And the real kicker...the deductible is higher and insurance no longer covers eye care or chiropractic care like I had before. It is mandatory that insurance in Colorado cover prenatal care though so as a 58 year old single male I feel good about that.
Wed Jul 29 21:08:26
Karen, With allndue respect, they are abusing the system NOW.It may or may not.get better, but it cant get worse if they are allowed to negotiate prices with the companies.

I get that it may not be ideal, but if medicare HAS to pay for it they should atleast be allowed to use leverage to lower cost.
Wed Jul 29 23:25:37
"With allndue respect, they are abusing the system NOW"

That is my point. So why give them even more latitude. Medicare doesn't have much leverage because they must provide the drugs. Pharmacies know this so may not be inspired to negotiate much for anything but the common drugs many companies can provide.
If the medicare program could shop other countries then maybe the US companies might come around some. Then maybe put in a rule that if US companies match the price of other countries medicare has to buy USA first?
Wed Jul 29 23:32:39
Kargen, I think that is part of the proposal, well sort of.

See I see that as still negotiating.
Wed Jul 29 23:37:17
You're completely forgetting that:

1. there are few drugs on the market that have only 1 supplier.
2. Medicare is a huge buyer and therefore wields power in negotiation.

Who gives a shit if Pharma A doesn't play ball with Medicare. B, C, or D will certainly be interested in making money. And a deal with Medicare means consistent high volume sales, the kind that look good for steady revenue.
Thu Jul 30 05:18:58
Canada as a nation negotiates with the drug companies. Their prices are consistently lower for the same drugs. Pretty sure Europe does the same.

Just imagine what kind of pharmaceutical manufacturing plant could be built if we took just 1 billion from the building of that useless wall on the Mexican border.

Start of manufacturing Insulin and offer it to the world. Make EPI Pens and do the same.

Take another billion and start manufacturing all the common vacines the world needs.

Take another billion and use it to make any drug the Pharmaceuticals create a shortage of. Eliminate their 'Gouging'.

We have colleges all across this nation and the rest of the world for that matter, that can do all the research needed to develop new drugs.

Leave big Pharma the cosmetics that they seem to be so invested in.
Thu Jul 30 05:55:45
Listen the wall is dumb. BUT forget the peanuts we spend on the wall think of how much we overpay for healthcare, probably way more.

I don't even see this being a partisan issue, it just seems to be the sort of woerd market where you sort of have to negotiate.
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