Trump could make changes to Medicare drug price negotiations
President Donald Trump will come to Washington, DC, in the Brady Pressonying Room in the White House on January 30, 2025.
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President Donald Trump is probably not eliminated with a pioneering procedure that enables Medicare to negotiate pharmaceutical prices with the manufacturers, even if he moves to deletion of Joe Biden’s other historical political achievements.
But Trump will probably make some changes to these price talks and may not require any help from the congress.
“Trump tries to nibble on the edges of the law,” said Matthew Kufferberg, a partner in Frier Levitt’s life sciences, and added that the president “does not want to give up the drug negotiation process at that time”.
However, it is still unclear in which way Trump will lean. While some legislators and health policy experts said Trump could weaken the negotiations in a way that helps the pharmaceutical industry, other experts said that he could double and try to save patients and the federal government even more money to exceed his predecessor.
The path he is entering could have big missions for prices for prices that the 68 million Medicare benefits in the USA pay for their medication. There will also be a big impact on companies such as having Novo NordiskPresent Bristol Myers SquibbPresent Pfizer And MerchantAmong other things, whose drugs were included in the first two conversations.
Negotiations are an important provision of the Inflation Reducation Act of Biden or the IRA, which aims to reduce the cost of prescription medicine for seniors and save the government almost $ 100 billion for Medicare output in the next decade. The pharmaceutical industry rejects the price talks and argues in a number of complaints that they threaten profits and discourage drug innovations.
The Trump administration offered only a few details about its approach to negotiations, apart from the statement in January that it will be striving for “greater transparency” in the current second cycle of the process and will hear ideas to improve external stakeholders.
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The law on significant changes or the abolition as a whole would be a tough struggle because it requires help from the congress, where the Republicans have slim majorities. Return with high health costs has a strong support in a nation in which patients pay two to three times more for prescription drugs than people in other industrialized countries, which makes it a potentially unpopular step for Trump.
Therefore, the Trump administration could implement the determination differently than bidges, including the change in the way, how the government interprets the selection criteria of the law on drugs.
“I think it’s a question of how to interpret part of the legal language,” said Juliette Cubanski, deputy director of the Medicare Policy program at KFF, an organization for health policy.
Cubanski said we can expect a first insight into all changes in the coming months.
The Trump administration will start the months of negotiating process for a second cycle of 15 medication, which will come into force in 2027. The bidding management selected these medication in January before Trump took up his office. By the end of February, drug manufacturers have to decide whether they should take part in the talks that they are likely to do because they are otherwise exposed to violent financial punishments.
What Trump could do alone
So far, Trump has given only the need for more transparency in the Medicare drug price negotiations. Kuperferberg said that this could mean to reveal more information about the government’s reasons for the selection of drugs or the agreement of prices.
During the first round of talks, Medicare offered opportunities for public contributions from patients, caregivers and consumer groups. But Kuperferberg said that the Trump government could move to get other stakeholders beyond manufacturers and patients, such as insurers or even middlemen who are referred to as Pharmacy Benefit Manager.
“It could be a much wider type of negotiation process,” he said.
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The administration could also reinterpret the guidelines of the law, which, according to Amy Campbell, Associate Dean for Law and Health Sciences at the University of Illinois Chicago School of Law, could change what products are selected and how many prices are decreasing.
According to IRA, the medication selected for negotiations must be on the market for at least seven years without generic competitors or 11 years for biological products such as vaccines. When choosing another drug round, the Trump administration may have “looser standards” to determine whether a medication has a competition on the market and should be released from the negotiated prices, said Campbell.
Trump could also revise what Medicare considered for a medication for the negotiations, said Kffs Cubanski. At the moment, various products that share the same active ingredient can be selected as a single product that contradicts the pharmaceutical industry.
For example, the bidges administration comprised three of Novo Nordisk’s brand medication with the same active ingredient – Semaglutide – as a product in the second cycle of the price talks. This includes the weight loss drug, wide pile, diabetes pill Rybelsus and the anti-adipositas injection Ozempic. Ozempic accounts for the lion’s share of the Medicare editions.
With one of these changes, as Medicare selects, medication can benefit and reduce the income that you lose through lower prices.
The greater question is how aggressively Medicare will negotiate prices under Trump as part of Trump, said Cubanski. At the moment, the final negotiated price for a medication must not exceed an upper limit or a “ceiling” price that is determined by the IRA.
Trump could influence whether Medicare’s initial offer for a medication is closer to the ceiling price, which could weaken the program of the program to secure a deeper discount.
Larger changes in the congress are a challenge
It is much less likely that the price negotiations at the price negotiations will negotiate because they would require congress help. For example, one of the biggest problems in the pharmaceutical industry with the process is what drug makers refer to as a “pills”.
The law economical biologicals such as vaccines from new negotiated prices for 13 years after they have received the US approval compared to only nine years for small molecular medication that are available in pill or tablet form. The industry claims that the discrepancy prevents companies from investing in the development of small molecule medication that is more convenient for patients.
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Cubanski said that non -partisan laws had been introduced last year that suggested to eliminate the pill penalty. If this calculation manages through the congress and Trump’s desk: “I don’t understand why he would not sign it,” said Cubanski.
She added that there seems to be a growing interest in changes in the law of the negotiating program, but “whether they receive enough support in the congress is still an open question.”
There is not the same support of the cross -party support for changes to IRA such as the reform of the Pharmacy Benefit Manager, said Jesse Dresser, partner in Frier Levitt’s bio -scientific department.
“I could see something like that [PBM reform] Most earned much earlier than I could see to open the IRA and optimize it, even if it is something that the administration could ultimately get behind, ”said chest of drawers.
The legal struggle is still pending
It is unclear how Trump will approach the ongoing legal dispute between manufacturers and the federal government compared to the Medicare program.
The legal challenges of the pharmaceutical industry, which argue that the conversations are unconstitutional and should be stopped, have so far been unsuccessful in court. Nine complaints were carried out in January.
“Will the Trump administration continue to defend the program? Or maybe not so aggressively the program?” Said Cubanski. “I think these are some important questions.”
If the Trump administration stops defending the program in court, the judges could make decisions on this matter without opposition, said Kuperferberg. But he said he didn’t think the administration wants to have this result.
The Trump administration would probably “want to take control of this process, in which the parties draw up an agreement or revise and change the interpretation of the law,” said Kuperferberg.
He added that it doesn’t look like Trump wanted the entire negotiation program to disappear due to the lawsuits. This is because it would be able to find a replacement for Medicare drug price negotiations, and we have “seen none of him yet,” said Kuperferberg.
