Republicans aren’t known for raising hell about prescription drug prices and fighting to keep them as low as possible for consumers. Call it a strength of the Democratic Party, but deference to markets has long been the standard for Republicans.
“Things cost what they cost” is an idea increasingly out of fashion on the political right.
On July 31, in the White House press briefing room, the GOP brand on drug pricing was turned inside out. Trump spokeswoman Karoline Leavitt delivered a 60-day ultimatum to U.S. pharmaceutical companies, reiterating to them the May executive order to enforce a “most-favored-nation” drug pricing policy.
Posted on the White House website in early August, the MFN factsheet indicates that letters were sent to 17 companies: Genentech, Gilead, GSK, Johnson & Johnson, Merck, Novartis, Novo Nordisk, Pfizer and others. The letters pay lip service to a genuine problem, which is that American patients subsidize the rest of the developed world’s drug prices and healthcare systems, but then veer directly into Democratic thinking on how to solve it — coercion.
MFN pricing imposes a ceiling on what pharmaceutical companies can charge for their therapies. Countries that wield them delay reimbursement, ration access or both. In France and Spain, the average wait between marketing authorization and public coverage for oncology drugs now exceeds a full year. European cancer patients wait 241 days longer than Americans for newly developed drugs.
When dealing with healthcare, these are life-and-death wait times and entirely the result of public policy choices.
The administration’s letters say U.S. pharma must provide American families “immediate relief from vastly inflated drug prices and an end to the free-riding by European and other developed nations on American innovations.”
Strangely, it says nothing about global trade agreements and the leverage the United States has in ending the free-riding by its closest partners, Canada and the United Kingdom.
Pharma costs are a historic punching bag of multiple administrations, and it’s hard to imagine Republicans stomaching such an assault on market principles from Joe Biden, Barack Obama or Bill Clinton. When Ronald Reagan moved to get lower prices for senior citizens with the 1984 Drug Price Competition and Patent Term Restoration Act, he slashed red tape slowing generic drug approvals. He provided more patent protections to incentivize drugmakers to keep investing in more breakthroughs.
The race-to-the-bottom mentality of MFN, even with Republican branding, is a massive setback for American leadership in medicine.
The United States has leverage, and the administration could make it clear that other nations should embrace free-market prices for American pharmaceuticals or risk losing access. Germans should pay what Americans pay, not the other way around.
If America plays by the rules set by European governments, the result is everyone in the world getting fewer new cures and delayed access to clinical trials. The administration could work with Congress to require pharmacy benefit managers to pass rebates to patients at the counter, publish their contracts, and stop the practices shown to inflate prices to their $7.3 billion gain.
These things aren’t sexy or easy political sells, but they work, whereas MFN would mean more American patients left in limbo and even longer wait times for Europeans.
The United States should stop bankrolling wealthy nations that ration care at the expense of Americans, and Trump can do better than this 60-day ultimatum for compliance with his MFN order. Attack the middlemen, tactfully negotiate with Canada, Britain and the EU, and let innovative American companies do what they do best — make breakthroughs that save lives.
Originally published here