President Donald Trump during an executive order signed at the White House Oval Office … more
Regarding Social, President Trump posted yesterday that the United States “will pay the same price as the nation that pays the lowest price anywhere in the world”. He wrote that prices would be reduced from 30% to 80% off their current levels, adding that he would sign “one of the most subsequent executive commands in history” this morning. But the series raises more questions than it answers. And possible logistical and legal challenges.
Trump reverses a plan from its first term in power towards PEG prices paid to the US in other comparatively rich countries in terms of gross domestic product per capita. Specifically, the model intended for the most favored nation will pay (returns to healthcare providers) no longer for high -cost drugs than lower price drug manufacturers they receive to other peer nations.
In 2018 and 2020, the Ministry of Health and Human Services proposed Different methods, including a MFN model, to reduce medicare prescription drug spending, linking the prices of medicines given to doctors to an international index consisting of a group of countries with similar per capita ADHC. An executive order issued by Trump in 2020 was blocked in the courts before it could be implemented.
In contrast to the proposal from the first administration, the executive order Signed today it seeks an MFN strategy at separate stages. First, he says that within a month of the date of the command, the secretary of HHS will “communicate with the most favored national point price targets to pharmaceutical manufacturers to bring prices for American patients according to comparatively developed nations”.
Given the differences in the timetable of drug launches between countries, setting prices by the return principles and dosage and packaging will be difficult to create a similar price indicator between the US and its peers. And the identification of privately owned net prices will be difficult in some international jurisdictions. Probably, HHS experts will be responsible. But after cuts to HHS, the office of the Assistant Secretary for the Planning and Evaluation Team is no longer used to help with such analyzes.
Legally, there would probably be challenges to the order that drug manufacturers are selling at MFN prices, as this could be considered to be violating the constitutional trade clause. This stipulates that only Congress has the power “regulating trade with foreign nations, between states and the Indian tribes”.
The executive then seems to “facilitate shopping programs directly to the consumer for medicinal manufacturers who sell their products to American patients at a very favorable price”.
Although there are exceptions, such as in the relatively new categories of weight loss of drugs, most businesses do not have a DTC medicine order in patients. And so, despite the help he has promised by the federal government, he is not guaranteed to be a smooth development if the plan goes so far.
In addition, the mandate seems to assume that the MFN values of drugs sold directly to patients would be smaller than those currently charged to the pharmacy meter. However, it is unknown whether this would happen to the majority of pharmaceuticals. In addition to the uninsured or those who do not have certain medicines covered as obesity drugs, most insured patients in Medicaid, Medicare and the Commercial Sector pay less in co-pay for most medicines in the pharmacy meter than a MFN price,
If DTC sales with MFN prices fail to implement or not achieve their goals, the HHS secretary “proposes a rules plan to enforce the pricing of favorable nations”. Here, however, the executive order has no details on which drug subsets will be included, which countries will participate in the establishment of an MFN index, how it will (through the mechanism), the administration intends to pursue its goals and to whom it will apply to the MEDICA and the MEDICA and the MEDICA. Commercially insured patients.
The White House says that “Americans must have access to the most favorable price of the point” for medicinal products and that they will take “immediate measures to end global loading”. Here, management nails part of the responsibility at the highest US prices in a “foreign nations” as they “force American patients to pay for a disproportionate amount of global pharmaceutical research and development, including suppression of the price of pharmaceuticals under fair market value”.
But this presupposes that drug prices abroad are “under fair market value”. This could be true. However, it is unaware of the fact that drug pricing in international markets is often subject to a rigorous process in which governments and quasi-government agencies are trying to determine the value of new entrants using the cost-efficiency and other measures and adjust the net prices.
One can challenge the methodologies used and if the principles of overseas authorities receive the alignment of price and the right value. However, Trump’s administration cannot ignore that a comprehensive cost-effectiveness and budgetary impact evaluation is based on most pricing arrangements. Therefore, it is extremely unlikely that other nations will contribute to manufacturers who increase the prices of pharmaceuticals. In addition, the restrictions of the government budget in Europe and elsewhere are tight, with strict rules on the cost of costing costs combined with the objectives of maintaining sustainable healthcare systems guaranteed by universal access.
As has been explained so far, the executive order to reduce drug prices in those of an MFN leaves critical details of its implementation and bypasses the supply and legal obstacles that may prove to be hard to overcome.
