President-elect Donald Trump on Wednesday pledged to change the way the federal government purchases prescription drugs, a dramatic warning to the drug industry that he is serious about keeping his campaign promises to address drug costs.

He gave the subject near-top billing in his first press conference as president-elect, slamming the pharmaceutical industry for overseas production and promising, in vague terms, to open up more price negotiations for medications.

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  • You can’t have it both ways. Bringing pharmaceutical production back to the U.S. would mean higher drug prices.

  • Trump gets it! Had he been in the White House, he would not have tolerated Big Pharma spending over $250 Million just to push the false promise of passing the Medicare Part D Act of 2002, which only denied Medicare the free market ability to competitively negotiate pricing, as it achieved for Big Pharma an open spigot at retail pricing. Given Trump’s position on those employed by the Federal government to make decisions in behalf of the taxpayer, and how he will not allow them to whore themselves at the expense of the taxpayer by later working for those firms, Trump would not have allowed the Chairman of the House Energy and Commerce Committee, Billy Tauzin (R-LA), to be immediately rewarded by Big Pharma for pushing passage of the one-sided Medicare Part D bill with the CEO slot at its largest lobbying group, PhRMA.

    Congress has historically failed to take appropriate action, given the overt dependence by both sides of the aisle in Congress on Big Pharma’s largesse distributed through its army of well heeded, and high heeled, lobbyists that the feedbags worn by Congress are always overflowing with donations. Trump will have to directly insert himself to solve the uncontrollable abuse of Big Pharma’s monopolistic powers to price at whatever the market will bear to extort excessive profiteering. The entire concept of an open, free market has been skillfully played by Big Pharma at the acquiescence of Congress. One reason the ACA is an unmitigated failure is the ‘echo chamber’ deal by the Obama Administration to perpetuate Big Pharma’s hold on pricing and profits.

    Trump’s blueprint to resolve this pressing matter is by declaring the USA will not be the last bastion for Big Pharma to rape, pillage, and plunder the taxpayers, as over 50% of our health care is now paid for by Medicare, Medicaid, and VA. Accordingly:

    1) Instruct Treasury and CMS to construct a market basket (weekly? monthly?) of how drugs are priced and at what percent profit in Canada, UK, EU, Switzerland, and Australia. We will take an average of those prices and profits which will structure our payment methodology for these monopoly products.
    2) Instruct DOJ to aggressively review and assert its authority to inhibit and prevent Big Pharma’s traditional reactions to pushback by the marketplace, including:
    a) Pushing the envelope of Anti-Trust by paying off the generic manufacturer to delay market entry; splitting profits from the continuance of the branded product.
    b) Unrelenting litigation attacking the generic manufacturer to delay market entry.
    c) Creating false ‘new and improved’ product patent(s) to continue life of the brand, as if it was just another detergent.
    d) Disrupting market forces by introducing coupons to discount branded product upon market entry of its generic; thus, increasing higher insurance and patient costs (e.g., Pfizer’s Lipitor).
    e) Acquisition of the generic manufacturer to overtly squash competition. Note how this is already a slippery slope with the memberships of large generics in PhRMA!
    3) Instruct FCC to reverse its 1997 ruling that allowed Big Pharma to directly advertise prescription products to the public, with the clear intent of pushing purchases through an unknowing public and around their physician. Limit all advertising to only be directed to clinical professionals; off TV and radio; treat like tobacco.
    4) Instruct DOJ and Treasury to create full transparency on how Big Pharma reports its taxes, costs, and profits, given how so much of its marketing costs are pushed into the opaque area of R&D.
    5) Instruct DOJ to revise rules for access by lobbyists to Congress and Federal offices. Given how over 50% of Big Pharma’s US profits are derived from taxpayer-funded health care programs, impose a strict limit to the dollar amount of donations by any firm or lobbying group of Big Pharma. It is simply not enough for Congress to ban Big Pharma’s promotional gifts to physicians, e.g., pens, when Congress so coarsely acts like flypaper to attract all those dollars–ironically paid for by and at the expense of the taxpayer.

    Hitting Big Pharma should be no different than hitting Lockheed or Boeing on their pricing; the only difference is at least those firms compete within their industry. Congress granted Big Pharma excessive monopolistic rights which have only perverted our concept of a free market, by extinguishing price negotiations and inhibiting competition.

    Frankly, any threat by Big Pharma to retreat from R&D in the face of these recommended changes is another false promise, as the USA remains its largest market.

    • Former insiders of the pharmaceutical industry in the U.S. tell me that around half the cost of developing a new drug is spent on advertising and lobbyists. In Europe, ads for drugs are banned. How much money for R&D would that alone allow? Plenty.

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