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House Passes Bill To Bring Down Price Of Prescription Drugs

MARY LOUISE KELLY, HOST:

OK. Now to a bill the House of Representatives passed today to lower prescription drug costs. This measure is a priority of House Democrats. It is not a bipartisan bill. President Trump has said he will veto it.

Joining us to explain what is actually in it and what might happen next is NPR health policy reporter Selena Simmons-Duffin. Hello. Welcome back.

SELENA SIMMONS-DUFFIN, BYLINE: Hi.

KELLY: So what is actually in this bill? What's it going to do?

SIMMONS-DUFFIN: The biggest thing that it does is - and the most controversial thing - is that it directs the secretary of Health and Human Services to directly negotiate with drugmakers over the cost of their drugs. So this isn't all drugs. They have to be drugs that are used in Medicare that are very expensive with no generic competition. And he would only - or he or she would only negotiate a few dozen drugs a year. But it's a big deal. It's - right now, it's prohibited. The prescription drug benefit was added in 2003, and they said that this was not allowed. The prices Medicare would get from these negotiations would also be offered to commercial insurers.

KELLY: I'm curious why the veto threat because President Trump has said that he likes the idea of negotiating with Big Pharma, and we would all like lower drug prices. So...

SIMMONS-DUFFIN: Yeah.

KELLY: So why veto?

SIMMONS-DUFFIN: He used to say that a lot. He said it on the campaign trail, in his first year in office, but he has not been saying that recently. And the White House came out with a report last week. The Council of Economic Advisers came out with a report that said 100 fewer drugs would be developed in the next 10 years if drug companies didn't think they could make really big profits off of their drugs. They wouldn't invest as much in development of drugs. So that's their main argument.

And also, Republicans in general really don't like the idea of direct negotiation. They call it government price control. It's not directly setting prices, but it is aggressive. And drugmakers would face really hefty fines if they didn't cooperate. So some other elements of this bill do have some bipartisan support - not that one.

KELLY: Like which ones? Which one do have bipartisan support?

SIMMONS-DUFFIN: So the two other really big elements of this bill are that it would cap the amount that seniors pay for prescription drugs out of pocket at $2,000 a year and that it would prevent price hikes for drugmakers that are faster than inflation for drugs and Medicare. So both of those ideas show up in a Senate finance bill from Senator Grassley of Iowa and Senator Wyden of Oregon. The White House likes that plan. But senator - Senate Majority Leader Mitch McConnell had seemed a little lukewarm about bringing it up.

KELLY: You've mentioned Medicare a few times...

SIMMONS-DUFFIN: Yes.

KELLY: ...Here, Selena. And if I'm hearing you right, all those things you just mentioned seem very narrowly focused on prescription costs under Medicare. Is that right?

SIMMONS-DUFFIN: Yeah. So the reason for that is we have a really fragmented system with lots of different insurers and plans. And no one has enough people to have enough clout to really change what drugmakers are doing except Medicare. It has - it's really, really big. Sixty million people are enrolled. Medicare beneficiaries use the most drugs. And what happens in Medicare influences what happens in the rest of the health care system because it's so big.

KELLY: I suppose the other thing to note here is Republicans oppose this bill.

SIMMONS-DUFFIN: Yes.

KELLY: So it's not likely to actually become law. What does happen with it next?

SIMMONS-DUFFIN: Well, it gives Democrats who go home for the holidays something to say to their constituents, like, we're doing something on this. Voters really care about it. It also puts pressure on the Senate leader to maybe bring up that bipartisan bill, saying that Democrats are doing something on prescription drug prices, and what are Republicans doing about it?

KELLY: NPR health policy reporter Selena Simmons-Duffin.

Thank you, Selena.

SIMMONS-DUFFIN: Thank you.

(SOUNDBITE OF NANEUM'S "STRATIFICATION") Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.