Alison Kodjak reported a story for NPR titled Here’s What The Feds Can Do To Cut Drug Prices (2017).

« Drug prices are too high, and we had better do something about it. That is the nutshell conclusion of a 201-page report from the National Academies of Sciences, Engineering and Medicine. »

« The independent advisory group’s report lists dozens of suggestions for what U.S. officials could do to rein in those rising prices. Many have been tossed around Washington for years. And given the power of the pharmaceutical lobby — it has spent more than $200 million on lobbying so far this year [2017], according to the Center for Responsive Politics — few of them are likely to be implemented soon. »

Law that that works against the public interest

« Trump himself has advocated for allowing the government, through Medicare, to negotiate lower prices for the drugs it buys. But doing so would take an act of Congress. Current U.S. law prohibits Medicare officials from interfering in the negotiations between drugmakers and the insurance companies that administer Medicare’s prescription drug program.  Medicare accounts for about 29 percent of all prescription spending, so bringing that purchasing power under one roof could give it the ability to force drugmakers to slash their list prices.  »

Anti-competitive dynamics

« It adds that Medicare and other government health plans also should have the authority to refuse to pay for medications that have cheaper equivalents or that aren’t adequately effective. Scott Gottlieb, the administrator of the Food and Drug Administration, has been preaching this message since he took office in May. “While FDA doesn’t have a direct role in drug pricing, we can take steps to help address this problem by facilitating increased competition in the market for prescription drugs through the approval of lower-cost generic medicines,” he said in a June blog post. The National Academies point to so-called “pay for delay,” where a branded drugmaker pays a generic company to delay putting its competitor drug on the market.  »

Lack of transparency

« The prescription drug payments system is a tangled web of prices, incentives, discounts and rebates among drug companies, pharmacy benefit managers and insurance companies…. The National Academies panel recommends that HHS require pharmaceutical manufacturers to report each year the list price of medications, along with all the rebates and discounts in the system and, finally, the average price paid for those drugs. »

Middlemen

« The dissenters suggest that pharmacy benefit managers have outsized power and take too much money from the system. »

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