WASHINGTON — President Trump finally signed a bill that he says will lower drug prices. But don’t ask him to explain how.
Flanked by members of Congress and pharmacists from around the country, Trump on Wednesday signed two bills banning so-called gag clauses, which prevent pharmacists from informing customers when it’s cheaper to buy a drug without insurance. Neither will directly lower prices; the changes will only affect what some people pay at the pharmacy counter.
But that’s not how Trump explained it.
“Obviously, based on the name, you can tell that this gives people knowledge as to prices at different locations, where to buy the drugs,” Trump said, referring to the title of the bills, the Patient Right to Know Drug Prices Act and the Know the Lowest Price Act. “They’ll be able to see pricing, they’ll be able to see where they should go and as they start leaving certain pharmacies, those pharmacies will be dropping their prices.”
Gag clauses, in reality, impact the life of pharmacists far more than they impact individual patients. They are contract provisions imposed on pharmacists by health plans and drug middlemen, and banning them won’t do anything to bring down list prices for pharmaceuticals.
Nor are patients likely to go shopping around for a new pharmacy. Pharmacies do not actually set what patients pay for a drug. That’s the purview of the drug maker, which sets the drug’s cash price, and the insurer or middleman, which sets the patient’s insurance copay.
Though his praise was misplaced, Trump’s signing ceremony today did mark the first legislative accomplishment to come out of his May blueprint aimed at lowering prescription drug prices. Every other win has been regulatory, and his other major attempt to push legislation through Congress, on putting drug prices into television ads, was foiled by his own party.
To Trump’s credit, even HHS Secretary Alex Azar said he didn’t know about the issue until Sen. Susan Collins (R-Maine) explained it to him. Collins, who spearheaded both bills, has said pharmacists told her about the issue.
And while Trump’s remarks might be in line with his propensity for sentiment over substance, they also highlight real questions about how exactly these laws would lower drug prices.
Like Trump, Americans can’t seem to make the connection. Only 42 percent of respondents in a July 2018 Politico-Harvard poll said they believed ending these agreements would lead to lower drug prices.
While there’s disagreement over how many patients are likely to encounter a gag clause, it’s indisputable that the law would do nothing to impact the prices drug makers set.
Public Citizen, which has been critical of Trump’s drug pricing plan, was quick to point this out in a Wednesday press release.
“The approach from the Trump administration and Congress so far has been like repairing a leaky faucet above while gallons of water spill from a pipe bursting below,” the consumer group wrote.