WASHINGTON — A patient advocate and a pharmaceutical industry representative went head to head Thursday on a proposal to peg U.S. drug prices to how much they cost in other countries — sparring over whether it is an idea whose time has come or the death knell for innovation.

Health secretary Alex Azar proposed last month a controversial change to the way Medicare pays for drugs administered in doctors’ offices that would tie some U.S. prices to the cost in other countries. The government would aim to pay about 30 percent less for certain drugs, with the price reduction for individual drugs related in some way to the average price of those drugs in certain other countries.

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