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Will Trump’s drug prices plan make a difference for patients?

President Trump revealed his blueprint to lower prescription drug prices as he railed against the pharmaceutical industry for making them unaffordable. Under his plan, "American Patients First," Trump proposes making it easier for generic drugs to enter the market and requiring drug makers to list prices in advertising. John Yang gets reaction from David Mitchell of Patients for Affordable Drugs.

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  • Amna Nawaz:

    Then-candidate Trump separated himself from other Republicans on the campaign trail with harsh words for drug makers and a pledge to tackle high drug prices.

    More than a year after he was inaugurated, the president came out today with his most extensive list yet of ideas to deal with the issue.

    But, as John Yang reports, there was immediate criticism that he backed off what would be the most significant changes.

  • John Yang:

    In the Rose Garden, President Trump revealed his blueprint to lower prescription drug prices, as he railed against the pharmaceutical industry for making them unaffordable.

  • President Donald Trump:

    We're also increasing competition and reducing regulatory burdens, so drugs can be gotten to the market quicker and cheaper. We're very much eliminating the middlemen. The drug lobby is making an absolute fortune, at the expense of American consumers.

  • John Yang:

    Called American Patients First, the president proposed to increase competition by making it easier for cheaper generic drugs to enter the market, bring down drug prices by requiring drug makers to list prices in advertising, use trade deals to force foreign governments to pay more for prescription drugs.

    The president argues that would lead to lower prices here.

  • President Donald Trump:

    In some cases, medicines that cost a few dollars in a foreign country cost hundreds of dollars in America, for the same pill with the same ingredients, in the same package, made in the same plant. It's unfair, and it's ridiculous, and it's not going to happen any longer.

  • John Yang:

    These moves are in addition to initiatives already offered in the administration's latest budget proposal, free generics for low-income seniors, and requiring insurers to share drug rebates with patients.

    Those require congressional approval. Mr. Trump has long championed lowering drug prices and assailed drug makers.

  • President Donald Trump:

    They're getting away with murder, pharma.

  • John Yang:

    As a candidate, he supported Democratic ideas to let Medicare negotiate drug prices directly with pharmaceutical companies, something now prohibited by law.

  • President Donald Trump:

    We don't do it. Why? Because of the drug companies, folks.

  • John Yang:

    The president has dropped that idea, persuaded, critics say, by the aggressive lobbying of the pharmaceutical industry.

    Alex Azar, Mr. Trump's health and human services secretary, is a former head of drug maker Eli Lilly's U.S. operations. This week, Novartis admitted to paying $1.2 million to Mr. Trump's former lawyer Michael Cohen to gain insight into the president. The company's CEO said yesterday it was a mistake.

  • Sen. Bernie Sanders, I-Vt.:

    Mr. President, if you are serious about lowering drug prices…

  • John Yang:

    Yesterday, liberal lawmakers called on the president to make good on his campaign pledges.

    Vermont's Bernie Sanders-

  • Sen. Bernie Sanders, I-Vt.:

    Tell the Republican leadership to support the Medicare Price Negotiation Act, so that we can do what every other country on earth is doing, and that is negotiate prices with the industry.

  • John Yang:

    This all comes as government data shows that the growth rate for prescription drug spending jumped from nearly 3 percent last year to almost 7 percent this year. And a Senate report released in March found that the prices for 20 of most commonly prescribed brand-name drugs for seniors under Medicare Part D increased 12 percent every year for the last five years.

    The president's plan is likely to take months to implement. There are a lot of groups affected by it.

    For the perspective of an advocate for patients, we're joined by David Mitchell. He's the president and founder of Patients for Affordable Drugs. He was diagnosed with multiple myeloma in 2010, and depends on continuous and expensive medications.

    David, thanks so much for joining us.

    What was your overall reaction to what you heard from the president and from Secretary Azar today? How much difference will this make?

  • David Mitchell:

    It's going to make some difference for some people, but the president promised us a home run, a grand slam home run.

    We got a bunch of singles and we got a couple of whiffs. There are some things in this set of proposals that will save money for some people, especially people on Medicare who are using very high-cost drugs.

    But the president promised that he would lower list prices. And if you look at the proposal, the shortest part is about lowering list prices, and we really have to get at list prices set by the drug companies if we're going to drive down prices overall.

  • John Yang:

    We're going to get some of the details, but first let me ask about something that wasn't there, something that he talked about in the campaign, talked about in the transition, allowing Medicare to negotiate directly with pharmaceutical companies on drug prices.

  • David Mitchell:

    Well, the president said repeatedly on the campaign trail that he supported direct negotiations by Medicare with the drug companies.

    Completely missing. We were hoping that at least they would do a demonstration project to allow states, five states, to try stronger negotiating tactics with the drug companies. That was in a proposal earlier this year from the White House, but that didn't show up either.

    We believe that direct Medicare price negotiations are important as part of the long-term solution to lowering drug prices. We can some progress with what was in the proposals today, but there's more that will have to be done, including that.

  • John Yang:

    The pharmaceutical companies don't like that idea. They say it would eat into their money that they spend on research and development. What do you say to that?

  • David Mitchell:

    Well, the fact of the matter is, taxpayers are doing most of the research and development for new drugs in this country.

    There was just a piece published by the National Academy of Sciences about six weeks ago that said every single one of the 2,010 drugs approved — I'm sorry — of the 210 drugs approved by the FDA from 2010 to 2016 were based on science paid for by taxpayers through the NIH.

    Drug companies wait until these drugs show promise, and then they swoop it, acquire the I.P. and charge crazy prices, $400,000, $500,000.

    The other thing is that drug companies spend more on advertising and marketing than they do on R&D. And then when they got the big tax windfalls from the tax cut, they used it to do stock buybacks.

    So the fact of the matter is, is there's plenty of room. This is a very profitable industry. There is plenty of room to lower prices and maintain a robust R&D pipeline, which I need. I have an incurable blood cancer. I need them to invent drugs, or I'm going to die sooner than I want to.

    But we can lower prices and still keep that R&D rolling, because mainly we're paying for it as taxpayers.

  • John Yang:

    You talked about bringing down the list prices of drugs.

    The one — the way they want to do this in the Trump administration is to have the FDA require drug companies to say the price in the advertising. Do you think that will make a difference?

  • David Mitchell:

    No, it's insufficient. It's a good thing. It's useful, but that's not going to lower list prices.

    They are going to do some other things. They said they are going to provide incentives to companies through Part D Medicare that will encourage companies to hold the line on pricing. But none of those things, so far, from what we can read, add up to a real effort to meaningfully lower list prices.

    They're stepping us in some useful directions. I don't want to lose that fact in this discussion, but there's much more that will have to be done.

  • John Yang:

    One thing the president hit hard on today was, he wants to use trade negotiations to get foreign countries to pay more for U.S.-made drugs. What do you think of that?

  • David Mitchell:

    The president and Secretary Azar say that foreign companies are freeloading.

    They're not freeloading. They're negotiating effectively for their citizens, which is what I want my government to do for me and all the other patients in this country.

    As a patient, it's very hard for me to think about the idea that a child with cystic fibrosis should have to pay more for her drugs in Britain so that I can pay less for my cancer drugs. That's wrongheaded.

    So, we disagree completely with that notion.

  • John Yang:

    The president also hit very hard at what he called the middlemen, the pharmacy benefit managers. First of all, I don't think a lot of people know who they are.

    Who are they, and will this help?

  • David Mitchell:

    Pharmacy benefit managers run your prescription drug insurance program. And they do the negotiating on behalf of the Medicare beneficiaries under Medicare Part D.

    They are secret. They negotiate all their deals in secret. They negotiate rebates. But no one knows how much of the rebate they keep, how much they give the insurer, what, if any, reaches me as a patient.

    So trying to get greater transparency from PBMs, insisting that PBMs actually act to the benefit of the patient, which is in their proposals, those are good things. And the PBM process is open to too much abuse. And tightening it up and having greater transparency will be good for people.

  • John Yang:

    The administration also wants to require drug plans, prescription drug plans, to pass on the discounts and rebates directly to the patients. What do you think of that?

  • David Mitchell:

    Well, there is good that can come from that.

    The actual proposal, I think, is that 30 percent of the rebates, the discounts, would be shared with patients at the pharmacy counter. That's useful. They also proposed to cap out of pocket for Medicare beneficiaries who are taking very expensive drugs. And that can be helpful to about a million people.

    That isn't nothing, but it isn't all that we require to do the long-term work to really bring down prices in this country.

  • John Yang:

    David Mitchell of Patients for Affordable Drugs, thank you very much.

  • David Mitchell:

    Thank you.

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