Trump will not call for negotiation on Medicare drug prices despite Democratic hopes

President Trump’s drug pricing plan will not include a call for Medicare to negotiate drug prices, a leading Democratic idea that Trump previously supported, a senior administration official said Thursday.

“We’re not calling for Medicare negotiation in the way that Democrats have called for,” the official said on a call with reporters previewing Trump’s speech on drug prices scheduled Friday.

However, the official said there will be other proposals to increase competition in Medicare, likely using private sector players rather than Medicare directly negotiating prices.

Democrats have been pressuring Trump ahead of his speech to renew his call for Medicare to negotiate drug prices, something that Trump touted on the campaign trail in 2016, in a break with Republican party orthodoxy.

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“We’re setting a high standard and hope that his proposal will meet that because we’d love to work in a bipartisan way to reduce costs,” House Democratic Leader Nancy Pelosi (Calif.) said at a press conference on drug prices Thursday ahead of Trump’s speech.

Instead of returning to the Medicare negotiation idea which would also have little if any chance of passing a Republican Congress, officials said Trump will propose a range of other ideas to bring down drug prices on Friday, though they did not get into details on what they will be.

Trump is also well known for going off script in planned speeches.

Officials said the “vast majority” of the ideas laid out in a “blueprint” on Friday will be actions the administration can take on its own, without congressional approval.

Secretary of Health and Human Services Secretary Alex Azar said earlier Thursday that the plan will go after “all aspects” of the drug pricing system, including going after drug companies directly.

However, much of the action is expected to be aimed at negotiators known as pharmacy benefit managers (PBMs) as opposed to drug companies themselves. PBMs have come under scrutiny for a lack of transparency, and lobbyists say reforms to their system of getting discounts from drug companies are likely.

Officials said Thursday that the proposals will include ways to crack down on “gaming” where drug companies prevent cheaper generic drugs from getting to market. Another proposal will go after foreign countries that officials said are free-riding on U.S. innovation in drug development.

Lobbyists say another likely proposal, which has been floated by the administration, is reforming how Medicare Part B pays for drugs, a system that is currently criticized as incentivizing prescribing of pricier drugs. Proposals could shift drugs into Medicare Part D, where there is more competition, or revive a 2003 program to increase competition called the Competitive Acquisition Program.