Dem overtures to Trump on drug pricing worry pharma

The Democratic takeover of the House is giving new life to efforts to fight high drug prices with bipartisan action, a worrying prospect for the pharmaceutical industry.

It’s a top priority for House Democrats, who now have powers to press the issue and put the drug industry on the hot seat. It’s also an issue where Democrats believe there is potential to reach a deal with President Trump.

{mosads}Democrats say the issue of health care powered their House victory in Tuesday’s midterms and at the top of their agenda is lowering health-care costs by targeting prescription drug prices.

Trump has also made fighting high drug prices a priority and his administration is moving on a new proposal to improve transparency about costs.

David Mitchell, founder of the advocacy group Patients for Affordable Drugs, said Tuesday was “a really good night for drug pricing.”

“We think the stage is set for bipartisan action,” he said.

House Democratic Leader Nancy Pelosi (Calif.) told PBS in an interview Tuesday that she thinks there could be “common ground” with Trump on drug pricing, and has touted the issue as a centerpiece of the party’s agenda.

Trump likewise on Wednesday during a press conference listed “lowering the cost of prescription drugs” as an area where he thinks he could work with Pelosi.

Any major action undoubtedly faces an uphill climb. Dealing with drug prices is an immensely controversial area, and drugmakers are a famously powerful industry in Washington. The Senate also remains in Republican control, another challenge to bringing legislation to Trump’s desk.

But backers of bold moves on drug pricing are hopeful.

“I think we can, and number two, I think we must,” said Rep. Peter Welch (D-Vt.), one of the House Democrats most vocal about taking on the issue of drug costs. “I think it can be bipartisan.”

Democrats have made it clear they intend to hammer away at the issue.

In the majority, they will be now able to conduct investigations into industry pricing practices and haul drug company executives in to testify. But ultimately, those moves won’t be as impactful as passing major legislation.

Many House Democrats have already introduced a number of bills on the issue. Rep. Elijah Cummings (D-Md.), who is expected to get the gavel on the powerful House Oversight and Government Reform Committee, has a bill to allow drug importation, a measure strongly opposed by the drug industry.

Democrats say that if they can get Trump on board with some of their proposals that could ease the path for moving legislation through the Senate.

Trump has previously endorsed Democratic-leaning ideas like having Medicare negotiate drug prices or importing drugs from abroad, but has not kept up support for those ideas while in office.

Democrats hope they can win Trump’s support back on Medicare negotiation, in particular.

“Whether this legislation becomes law is very much in the president’s hands,” said Rep. Lloyd Doggett (D-Texas), sponsor of a Medicare negotiation bill in the House along with Welch.

He said presidential leadership would be needed to get through drug company lobbying and resistance in the Senate.

Senate Republicans may already be feeling some pressure.

Senate Majority Leader Mitch McConnell (R-Ky.) has expressed some openness to addressing drug pricing next year, though he did not offer specifics.

“I can’t imagine that that won’t be on the agenda,” McConnell said at a press conference Wednesday.

It’s also possible that smaller drug pricing actions could be attached to larger bills, such as must-pass spending legislation. Drug-pricing advocates have long pushed for the Creates Act, which seeks to crack down on delay tactics against approval of cheaper generic drugs, and that measure has bipartisan support.

The Pharmaceutical Research and Manufacturers of America (PhRMA), the main drug industry trade group, though, will be on high alert over any moves on pricing.

In a statement Wednesday, Holly Campbell, a spokeswoman for PhRMA, reiterated the group’s message that blame should fall on other actors in the supply chain, like pharmacy benefit managers and insurers, who often do not pass along discounts to patients.

“We can’t speculate on what Congress may or may not do, but we remain focused on advancing market-based reforms that address misaligned incentives in the biopharmaceutical supply chain and lower out-of-pocket costs,” Campbell wrote in an email to The Hill.

Democratic hopes of working with Trump on major legislation on issues like immigration and gun control have fallen through before after showing some signs of promise.

Trump warned Wednesday that if House Democrats open investigations into his administration he would shut down bipartisan cooperation on legislation and “government comes to a halt.”

But by controlling the House, Democrats can ramp up the pressure. If they struggle to get Trump or Republicans on board, Dems can still line up votes on pricing measures that prove popular with the public, sending them to the upper chamber to embarrass McConnell or even drive a wedge between him and Trump on the issue.

It’s still unclear where Democrats and Trump might find common ground.

Trump has recently taken some actions on his own to try to lower drug prices, evoking mixed reactions from Democrats who praised him but also urged him to go further.

Democrats offered praise for a proposal that would force drug companies to disclose their prices in television ads, but said more must be done.

The specifics of any legislation House Democrats will push for on drug pricing are also not yet clear.

But several key Democrats pointed to allowing Medicare to negotiate drug prices on Wednesday, long a goal of the party.

Both Welch and Doggett said they thought at least some House Republicans would end up voting for a Medicare negotiation bill if it were brought to the floor.

Doggett said he expects there could be revisions to his current bill on the subject. Lawmakers will discuss the issue further after they return to Washington, starting next week.  Welch said he hopes any legislation goes through the standard committee process.

Pelosi noted that Democrats ran on allowing Medicare to negotiate in 2006, but were unable to get it into law.

“We hope to get that done now because that is a big impact on America’s families’ budget,” Pelosi said Wednesday.