With the presidential election less than two months away, we’re taking some time to see where the candidates stand on prescription drug access and affordability issues – and glance at the national positions of the Democratic and Republican parties. Drug prices are not a good issue for the candidates to ignore, as tens of millions of families across the nation are impacted. According to a study in the Journal of the American Medical Association, almost 60% of American adults took at least one prescription drug in 2012, with 15% taking five or more medications. Moreover, the cost of prescription drugs is their number one healthcare concern.
A 2015 poll by the Kaiser Family Foundation found that 76 percent of U.S. adults think that the top healthcare priority for the current Administration and Congress should be “making sure that high-cost drugs for chronic conditions, such as HIV, hepatitis, mental illness and cancer, are affordable to those who need them.” Recent headlines, such as those featuring the EpiPen price hike, further highlight the public’s outrage over the soaring cost of prescription medications.
Medicare is one of the largest purchasers of prescription medications in the U.S., however it is expressly prohibited from negotiating with pharmaceutical companies over the price of medications. This ban was put in place in 2003 when the Medicare Prescription Drug, Improvement and Modernization Act (MMA) was signed by President George W. Bush. Legislation is on the table to repeal the ban.
During her 2008 race for U.S. President, Hillary Clinton supported Medicare leveraging its significant purchasing power with pharmaceutical companies to reduce spending on prescription drugs and continues that stance today in her 2015 healthcare plan.
During the primaries, Donald Trump initially expressed support for Medicare negotiating drug prices with pharmaceutical companies – supporting a position that Democrats have backed and Republicans have opposed for years. During a campaign event in Farmington, N.H, Trump was quoted by the Associated Press that Medicare could save $300 billion a year if it negotiated discounts, which was a highly exaggerated claim. The Trump campaign has not published support of this policy and it is not included in his seven-point healthcare plan.
One of the reasons many Americans are paying far too much for their prescription drugs is a result of the pharmaceutical company practice of “pay-for-delay” or “reverse payment agreements”, which delays the introduction of far less expensive generic medications from entering the marketplace – forcing consumers to pay a much higher price for a brand name drug. There is proposed legislation to make these deals illegal.
According to her healthcare plan, Hillary Clinton would prohibit “pay-for-delay” agreements that allow drug manufacturers to keep generic competition off the market – lowering prices for Americans, and saving the government up to $10 billion.
Donald Trump has not released a specific position statement on this issue.
Hillary Clinton has long been an outspoken critic of the pharmaceutical industry. Her healthcare plan, released last September, includes holding pharmaceutical companies accountable for egregious price hikes, and encouraging more investment into research to stop companies from simply acquiring drugs and increasing their price.
Following the public outrage on the EpiPen price hike, Hillary Clinton released a new plan to protect Americans from unjustified price hikes in lifesaving treatments that have long been on the market. Part of her plan includes creating a drug-pricing oversight group that will monitor price increases. Where the group finds increases unjustified, it could allow the Federal government to buy and provide alternative therapies to patients, import lower-priced drugs from foreign countries on a temporary basis and impose fines on pharmaceutical companies that excessively raised prices.
Clearly, Clinton has a much more ambitious and serious plan to tackle high drug prices and is highly critical of pharmaceutical industry practices. However, Trump correctly recognizes that “Congress will need the courage to step away from the special interests and do what is right for America.” In that statement, he means make it lawful for Americans to purchase lower cost imported medications.
We’re pleased that Trump and Clinton agree on the importance of expanding access to lower cost personally imported medications. On the other hand, the Democratic and Republican party platforms are fundamentally different on the issue of prescription drug affordability.
The Democratic platform includes support for a cap on monthly out-of-pocket costs for prescription medications, drug price negotiation with the pharmaceutical industry by Medicare, importation of lower-priced drugs from other countries, and prohibition of pay-for-delay agreements that delay generic drug entry into the marketplace.
The Republican platform does not state a position on prescription drug issues including personal drug importation. But Republican voters, ironically, are in favor of many of the policies articulated in the Democratic policy platform and contrary to their own party’s platform. For example, 74% of Republicans support Medicare drug price negotiations and 70% support price caps for the most expensive medications that treat cancer and Hepatitis C.
Of particular interest is that 76% of Republicans support the express legalization of personal drug importation from Canada compared to only 69% of Democrats.