Tuesday, September 17, 2019


President Trump is reportedly planning his most ambitious executive order yet. It would require pharmaceutical companies to sell drugs to Medicare and Medicaid for the same prices they charge in other developed countries, where medicines are often far cheaper.  

That might sound like the sort of bold, America-first policy we need to make drugs more affordable. It’s deeply unfair that wealthy nations like Canada and Germany can purchase medicines — typically invented in the United States — for a fraction of the price that Americans pay.

But the strategy would backfire. Price controls would yield short-term savings for patients and taxpayers — but they’d also deter future research investments and choke off the development of new drugs. The policy would leave Americans worse off in the long run. Let’s hope the administration chooses a smarter way to reduce patients’ drug costs.

Medical innovation is a high-risk, high-expense endeavor. Less than 12 percent of experimental therapies that undergo human testing ultimately prove effective enough to receive FDA approval. Because of this high failure rate, it costs more than $2.5 billion to bring just one new drug to market.

Investors willingly fund risky research projects as long as there’s a chance to profit from a successful medicine. Big pharmaceutical companies poured almost $80 billion into research and development in 2018 alone. Smaller biotech firms invested billions more.

Thanks to such investments, U.S. labs produce over half of all new medicines developed worldwide. America leads the world in drug development precisely because it doesn’t artificially cap the price of medicines.

This innovation saves lives. In the United States, death rates from HIV/AIDS have plummeted close to 90 percent since the mid-1990s thanks to new antiretroviral treatments. Cancer deaths have fallen 27 percent over the last three decades, mostly because of better drugs. Five-year survival rates for chronic myeloid leukemia have risen by almost 60 percent since 2001, when the first drug to treat the cancer was approved.

This progress shows no signs of slowing. Roughly three-quarters of drugs in the clinical pipeline are potential “first-in-class” medicines for Alzheimer’s disease, diabetes, cancer and more. That means they’re unlike any other drugs on the market.

Price controls would eliminate companies’ incentives to invest in drug development. Why would firms spend billions on research if there’s no hope of eventually turning a profit or even recouping their development costs?

If the president’s potential executive order — or a proposed plan that would index Medicare reimbursements for advanced drugs to the prices paid in other countries — goes into effect, patients would enjoy far fewer new cures.

Fortunately, the president can deliver savings to patients without resorting to price controls. His aides at the Department of Health and Human Services (HHS) already developed — but then inexplicably shelved — a great plan to reform the drug supply chain.

Each year, drug makers offer well over $100 billion of discounts on their products to insurers and other middlemen in the drug supply chain. But patients rarely benefit from these savings at the pharmacy counter. That’s because insurers and middlemen capture these rebates themselves, instead of using them to reduce patients’ out-of-pocket costs.

The HHS proposal would have forced insurers and other middlemen to share those discounts directly with Medicare beneficiaries in the form of lower copays and coinsurance. According to an analysis from consulting firm Milliman, the rule could have reduced Medicare beneficiaries’ prescription drug spending by 11 percent and saved the federal government up to $98 billion over the next decade.

These savings would have made it easier for patients to stay healthy. Up to 125,000 Americans lose their lives each year because they don’t adhere to their prescriptions. This prescription “non-adherence” is responsible for 10 percent of hospitalizations and costs the U.S. health care system up to $289 billion every year.

Additionally, instead of embracing ill-conceived price controls, the administration should be pressuring other nations, especially European countries, to abandon such policies so that the United States does not have to foot the bill for most of the world’s pharmaceutical research and development.

Imposing price controls on Medicare might generate short-term savings — but it’d cut off the research funding that yields new cures. President Trump would be wise to shelve this proposal and concentrate on slashing Americans’ out-of-pocket drug costs.

• Bob Beauprez, a former Republican U.S. representative Colorado, is a Republican candidate for governor of Colorado.

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