Lawmakers rushed into the drug pricing arena this week as they revived a bundle of legislation and oversight talks, signaling they want to put manufacturers in the hot seat when it comes to addressing healthcare costs.
Medicare negotiation was at the forefront of Democratic messaging with an unexpected Republican boost. Rep. Tom Rooney (R-Fla.) joined Rep. Peter Welch (D-Vt.) to re-introduce legislation to allow the HHS secretary to directly barter with manufacturers on behalf of Medicare Part D. Rooney is the sole Republican to co-sponsor the bill so far.
On Thursday, Sen. Amy Klobuchar (D-Minn.) revived the upper chamber’s companion bill as Sen. Bernie Sanders (I-Vt.) held a press conference to tout this and other measures, promising an end to pharma “greed.”
But it’s unclear how aggressively Congress will end up legislating on the issue and how lawmaker action will play into HHS Secretary Alex Azar’s proposal to tie Medicare Part B prices to the lower prices paid in other comparable countries.
One of the decisive figures in the upper chamber, Senate Finance Committee Chuck Grassley (R-Iowa), told reporters on Wednesday that he remains opposed to direct government negotiation despite other vast areas where he sees himself working with Democrats on drug prices.
A key architect of the law that created Medicare Part D in 2003, Grassley said he will prioritize policies to modernize the program, with an eye on how manufacturers might be gaming the current system. But he emphasized that he doesn’t want direct government negotiation with the private sector and doesn’t see the need as Part D has consistently come in under budget.
“Going back for a full 10 years, [Part D] has basically come in under budget by about 40%,” he said. “If it’s working, don’t mess with it.”
But Grassley has yet to take a firm position on Azar’s proposal for the international price index for Part B, telling reporters that he will discuss the policy with the secretary after the public comment period closes.
“Initially, I don’t want foreign countries to set our drug prices,” he said. “What can he do to modify that so that principle is not violated?”
Related to Azar’s proposal, Sanders introduced his own coordinated effort with Rep. Ro Khanna (D-Calif.) that would make the international benchmark policy law. Sanders promised he would do so at the end of last Congress.
Lawmakers also paved the way for industry oversight, as Grassley made it clear he will focus on anticompetitive issues with drugmakers.
He joins other key lawmakers with oversight jurisdiction. House Oversight Committee Chair Elijah Cummings, a Maryland Democrat, on Thursday announced that his first hearing scheduled for Jan. 29 will focus on high drug prices.
Rep. Raja Krishnamoorthi (D-Ill.), who chairs the health subcommittee for oversight, told Modern Healthcare that he expects to call pharmaceutical executives before the panel as well.
Grassley threw his support for three additional bills that didn’t make it through the last Congress. He is sponsoring a measure with Klobuchar to crack-down on manufacturer pay-to-delay tactics that stall generics from entering the market. The two senators also are reviving a measure championed by the late Sen. John McCain to allow people to import prescription drugs from Canada for their personal use.
He also plans to move the Creates Act, a joint effort with Sen. Patrick Leahy (D-Vt.) that passed out of the Senate Judiciary Committee last summer. Creates Act aims at expediting generic drugs and biosimilars to market but has faced opposition from the pharmaceutical trade group.