Where top 2020 Democrats stand on drug pricing

Democrats running for president are vowing to push for policies to rein in rising drug costs, a top issue for voters in 2020, according to polls. Democrats argue President Trump has done little to address high drug prices, despite vowing to do so in his 2016 campaign. But within the Democratic field, there are a number of stark differences between the candidates on the issue. 

Here’s where the top Democratic presidential candidates stand on tackling high drug prices.

Former Vice President Joe Biden 

Biden said he would repeal a provision of federal law that prohibits Medicare from negotiating prices with drug companies, a proposal that is popular among other Democrats running for president.

Democrats argue Medicare has the leverage to negotiate lower prices than it is paying now because the program covers millions of Americans. 

And Biden said he would also limit what he called the “abusive” prices companies set for new, specialty drugs that can often cost thousands of dollars.

Because these drugs have no competition, he argues, companies get away with pricing their products at exorbitant rates.

Under Biden’s plan, the Department of Health and Human Services (HHS) would establish an independent review board to assess the value of these drugs. That price would be paid by Medicare and the public option. 

“Too many Americans cannot afford their prescription drugs, and prescription drug corporations are profiteering off of the pocketbooks of sick individuals,” Biden’s plan reads.

Prices for branded, biotech and “abusively priced” generic drugs would be limited to the rate of inflation. 

Biden’s plan would also let Americans import cheaper prescription drugs from other countries. 

While that idea has mostly gained traction among Democrats, it is also a key element of the Trump administration’s drug pricing effort.

In July, HHS outlined its steps to begin pilot drug importation programs by states and agencies. But the effort is a long way off and likely to face staunch opposition from the pharmaceutical industry which has raised safety concerns.

Sen. Elizabeth Warren (D-Mass.)

Lowering health care costs is one of Warren’s chief campaign promises, one she has promised to fix by cracking down on what she calls noncompetitive industry practices.

Warren has proposed letting the government manufacture generic drugs in some cases, for example when there is no competition for a drug that is on the market or if there is a shortage of a particular drug. 

Warren also supports “Medicare for All,” sponsored by Sen. Bernie Sanders (I-Vt.), which would let the government negotiate prices with drug companies. 

In a Warren administration, drug companies that continue to price their drugs at what the government deems unaffordable levels will lose their patents and have them given to a company that will make the drugs at a cheaper price.

That idea has support not only among progressives such as Warren’s fellow 2020 contender Sen. Kamala Harris (D-Calif.), but also more centrist presidential contenders, such as South Bend, Ind., Mayor Pete Buttigieg (D) and Sen. Cory Booker (D-N.J.), who support similar proposals.

In all, Warren says her suite of policies will bring down Medicare prices for brand name drugs by 70 percent and 30 percent for generics. 

Sen. Bernie Sanders (I-Vt.)

Sanders has consistently fought back against high drug prices throughout his career. He first led a busload of people to Canada in 1999 to buy prescription drugs that were much cheaper than in the U.S. He completed a similar trip as a presidential candidate in July. 

“We should be doing what the Canadians do, and that means sitting down with the drug companies and negotiating a price,” Sanders said.

He also supports letting Americans, pharmacists and wholesalers import prescription drugs from Canada and other major countries. 

Sanders has also introduced bills in the Senate that would peg what the U.S. pays for prescription drugs to the median costs in other countries. 

Sanders and fellow 2020 contenders Harris and Booker also introduced a bill last week that would create an independent federal agency — the Bureau of Prescription Drug Affordability and Access — to set the prices of prescription drugs. The agency would review information on a drug company’s costs to develop the drug, what comparable drugs cost in other countries and any federal spending that helped develop the drug in proposing a price.

The agency could also void patents if companies do not comply with regulations, allowing others to manufacture cheaper versions of the drug.

South Bend, Ind., Mayor Pete Buttigieg

Buttigieg also supports giving Medicare the ability to negotiate prices with drug companies.

His public option plan, which would allow anyone to buy into the Medicare program, would cap out-of-pocket drug spending at $250 per month. His plan would also cap drug prices for seniors in the program at $200 a month. 

There would be no co-pays for generic drugs for people with low incomes who are insured by Medicare, the public option or Medicaid.

Buttigieg’s administration would also require drug companies to pay rebates if their drug prices increase faster than the rate of inflation. 

Sen. Kamala Harris (D-Calif.)

Harris also supports allowing Medicare to negotiate drug prices. She would also direct HHS to set a “fair price” for prescription drugs that are cheaper in other countries or if the price of a drug increases by more than the cost of inflation. Any profits companies make from selling drugs above that determined price will be taxed at a rate of 100 percent and that money will be sent back to consumers, Harris’s plan reads. 

If Congress doesn’t act to address high drug prices within her first 100 days in office, Harris says she will investigate pharmaceutical companies with high prices and make the information public. 

If a drug doesn’t drop in price, Harris’s administration would also let HHS import cheaper alternatives from other countries, such as Canada.