Morning Briefing
Summaries of health policy coverage from major news organizations
Democrats See Opportunity In Trump's Inaction To Reclaim High Drug Prices As Winning Issue
The Washington Post: Trump Made High Drug Prices His Issue. Democrats Think They Can Take It Back.
Democrats are trying to take back an issue Donald Trump effectively stole from them during the 2016 presidential campaign: the high cost of prescription drugs. Trump repeatedly railed against pharmaceutical companies during the campaign and after taking office, promising that prices would drop and accusing drug companies of “getting away with murder.” But more than a year into his tenure, Trump has taken only limited action, and drug prices continue to climb. (Werner and Johnson, 5/7)
Bloomberg: Drug Plans Drop After Trump Official Targets PBMs Ahead Of Speech
Shares of CVS Health Corp. and Express Scripts Holding Co. slipped Monday after one of the Trump administration’s top health-care officials said the companies’ roles as intermediaries between drugmakers and health plans was hurting patients. Known as pharmacy-benefit managers, or PBMs, the plans negotiate with drugmakers to put their products on lists of covered drugs in return for discounts, and steer patients toward options that they say save them and employers money. Those dual roles are in conflict, said Seema Verma, administrator of the Centers for Medicare and Medicaid Services. (Flanagan, 5/7)
Stat: CMS Chief Criticizes Medicare Drug Payments For 'Perverse' Incentives
The Trump administration on Monday offered a new critique of the way Medicare pays for drugs administered by doctors, hinting at potential changes that could draw broad ire from drug makers, hospitals, and doctors. Centers for Medicare and Medicaid Services Administrator Seema Verma said the payment structure for Medicare Part B, which covers chemotherapy treatments and other physician-administered drugs, “creates a perverse incentive for manufacturers to set higher prices, and for providers to pick drugs that are more expensive.” (Mershon, 5/7)
And in other news —
Stat: Longtime Head Of Pharmacy Benefit Manager Trade Group To Step Down
Mark Merritt, who has helmed the pharmacy benefit manager trade association for the last 15 years, will step down at the end of this year, the group announced Monday. The Pharmaceutical Care Management Association has not yet said who will take over from Merritt, but board chairman Tim Wentworth of Express Scripts said in a press release the group would launch a search for his successor. (Mershon, 5/7)
Kaiser Health News: Medicare Beneficiaries Feel The Pinch When They Can’t Use Drug Coupons
Under the federal anti-kickback law, it’s illegal for drug manufacturers to offer people any type of payment that might persuade them to purchase something that federal health care programs like Medicare and Medicaid might pay for. The coupons can lead to unnecessary Medicare spending by inducing beneficiaries to choose drugs that are expensive. “The law was intended to prevent fraud, but in this case it also has the effect of prohibiting Part D enrollees from using manufacturer copay coupons … because using the coupon would be steering Medicare’s business toward a particular entity,” said Juliette Cubanski, associate director of the Program on Medicare Policy at the Kaiser Family Foundation. (Andrews, 5/8)
