WASHINGTON — Confronted with Donald Trump’s unorthodox position on drug prices, the president-elect’s nominee to be secretary of health and human services on Wednesday appeared wary of proposals to allow Medicare to pursue negotiations on prescription drugs.
Congressman Tom Price, the Republican nominated by Trump to lead HHS, was asked by Democratic lawmakers whether he would agree to support empowering Medicare to negotiate prices with drug companies. After initially sidestepping those questions, he seemed to suggest that the policy would at least be considered, given Trump’s outspoken support for it, but he expressed no enthusiasm for the proposal.
Price was answering questions before the Senate health committee, which held a courtesy hearing on his nomination. Much of the early discussions focused on repealing the Affordable Care Act and Price’s alleged conflicts of interest in his health care investments.
But then Senator Bernie Sanders of Vermont, an independent who ran for the Democratic presidential nomination last year while railing against the drug industry, turned to Trump’s position on drug prices. The president-elect sent chills through the industry last week when he said drug makers were “getting away with murder” and vaguely promised to change how the federal government pays for drugs.
It is usually a policy endorsed by Democrats, not Republicans, and many have wondered whether Price and congressional Republicans would agree to Trump’s plans to lower drug costs if he seriously pursues them.
Democrats clearly saw an opportunity to pin down other Republicans on the issue, which polls show are consistently a top concern for Americans. Sanders seized on Trump’s comments as he questioned Price.
“Will you and will the president-elect join us in legislation we’re working on,” Sanders asked, to allow Medicare to directly negotiate the prices it pays for drugs and to allow drugs to be imported from other countries, particularly Canada?
“The issue of drug pricing and drug costs is one of great concern,” Price said, though he pointed to the proliferation of generic drugs as one way costs had been kept down.
But Sanders pressed on.
“We are paying by far the highest prices,” he said. Price said he thought that was true, but that there were “a lot of reasons for that.”
Sanders countered that “every other major country on earth negotiates” the prices it pays for drugs, but the United States does not and “the drug companies can raise their prices” without any consequences.
“Will you work with us so that Medicare can negotiate prices?” Sanders asked again.
“You have my commitment to work with you to make sure drug pricing is reasonable,” Price said.
Sanders was unsatisfied. “That wasn’t quite an answer to the question,” he said, before moving on.
But the Democrats in the minority didn’t let the matter go. Senator Tammy Baldwin of Wisconsin raised Trump’s support for direct Medicare negotiations for drugs again later in the hearing.
After Price agreed that there are “certain areas where drug pricing increases seem to have little basis in rational findings,” Baldwin asked: “Will you work to repeal the prohibition on Medicare negotiating for better drug pricing?”
“The boss that I have will be the president of the United States,” Price replied.
“So will you work to repeal the prohibition?” Baldwin asked again. Price said his role would be “carrying out [Trump’s] wishes.”
“Is that a yes or no?” Baldwin said. Price said it would depend, but Baldwin interjected.
Trump has “stated his position very recently on Medicare price negotiations,” she said. “Is that something you would press Congress to do?”
“I think we need to find solutions to the challenges,” Price said, before finally allowing: “It may be that one of those is changing the way the negotiations” for the prices Medicare pays for drugs are conducted.
Price also then said, in response to a question from Baldwin about requiring drug companies to make disclosures to justify price increases, that he thinks “there is a merit to transparency and certainly in this area.”
Another Democrat, Senator Sheldon Whitehouse of Rhode Island, addressed another issue in drug pricing during the hearing. He zeroed in on the ACA’s closing of the Medicare donut-hole — a glitch in federal policy that forced seniors to pay full price for their medicines after they hit a certain dollar threshold.
The health care law fixed that glitch, but supporters have warned that repealing the law could lead to the problem reappearing and seniors being on the hook for hundreds of dollars in drug costs.
“Are you going to be proposing in that plan to reopen donut hole?” Whitehouse asked Price, after noting the HHS secretary would likely be involved in the legislative and technical work to repeal and replace the ACA.
“I’m not aware of any discussion to do that,” Price said.
Otherwise, Democratic warnings of the consequences of repealing Obamacare and Republican reassurances that they would repeal the law responsibly dominated the hearing — as did the minority’s grilling of Price’s investments.
Price, who has been in Congress since 2005, has been under fire the last few weeks for alleged conflicts of interest related to health care legislation he supported and companies he invested in. As first reported in STAT, Price has in recent years traded stock in Amgen, Eli Lilly and Co, Prizer, Biogen, Bristol-Myers-Squibb, Zimmer Biomet, the medical device firm, Gilead, Thermo Fisher Scientific and Abbott Laboratories.
But it is holdings in Innate Immunotherapeutics, Ltd., a biomedical company in which Rep. Chris Collins is a major shareholder, which has drawn the most criticism. According to his financial disclosure statements, as STAT reported last month, Price bought between $50,001 and $100,000 worth of stock the firm on August 31.
Collins, a New York Republican, is a director of the company, which develops drugs to treat multiple sclerosis. He lists assets in the firm worth between $5,000,001 and $25 million. Price also purchased a smaller amount of stock in Innate Immunotherapeutics in 2015.
On Wednesday, under questioning by ranking Democrat Patty Murray, of Washington, Price acknowledged that he first heard about the company from Collins.
Price repeatedly said he did not gain special access, or a discount, but the stock was not available to the general public — and rose soon after his August purchase.
Several other episodes have been reported in which Price appeared to invest in a health care company and then push legislation that would boost its business prospects.
Democrats have called for a federal investigation into the controversies and pressed Republicans to delay Price’s confirmation until the matter is resolved.
The Trump transition team has pushed back, saying that the trades were made by a broker without Price’s knowledge and alleging that press reports have left out key facts.
On policy matters, Price has also, at times, found himself at odds with Trump. He has supported a major overhaul of Medicare; Trump pledged repeatedly throughout the campaign not to cut the program. Price’s plan for replacing Obamacare does not appear to meet Trump’s stated preference for universal coverage.
Trump has said he does not want to move forward with his health care overhaul plans until Price is confirmed. Wednesday’s hearing was the first of two: Price will go before the Senate Finance Committee next Tuesday, and the committee will then vote on his nomination.