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Reference price bill tabled in US House and Senate

The new measure could reduce median drug prices by around 43%

Former US presidential candidate Bernie Sanders has introduced a bill in the Senate that would peg US prescription drugs cost at no more than the median price of medicines in Canada, the UK, France, Germany and Japan.

Bernie Sanders

Bernie Sanders, Independent Senator, Vermont

The Senate bill is matched by a similar version in the House, tabled by Ro Khanna (Democrat-California), and would give the government the power to approve generic versions of drugs if manufacturers insist on maintaining process above that level. Both texts claim that the measures would reduce median drug prices in the US by around 43%, with even higher reductions in some cases.

Adopting this policy would slash the monthly cost of AbbVie’s Humira for arthritis and other inflammatory conditions to $1,576 from $2,770, say the bills, which also lists potential savings for several other drugs including Pfizer’s hormone replacement therapy Premarin (conjugated oestrogens),  Merck & Co’s Januvia (sitagliptin) for diabetes, and Astellas/Pfizer’s prostate cancer therapy Xtandi (enzalutamide).

Sanders (Independent – Vermont) – who ran against Trump for the presidency but has common ground with him on this issue – said that the “greed of the prescription drug industry is literally killing Americans and it has got to stop”. Reference pricing is one of the proposals that has been put forward by Trump since he published a blueprint to reduce medicine prices earlier this year.

“No other country allows pharmaceutical companies to charge any price they want for any reason they want. Somebody in America today can walk into a pharmacy and find out that the medicine they have been using for years can double, triple or quadruple literally overnight.”

The move comes two weeks after the US mid-terms saw the Republicans lose their majority in the House but consolidate their hold on the Senate, which some observers interpreted as making it less likely that President Trump’s plans to restrict drug prices would make it onto the legislature.

A few days later, Pfizer said that it would raise the prices of 41 prescription drugs from 15 January next year, having deferred the rises earlier this year when Trump was placing pressure on the industry to moderate its practices.

Pfizer CEO Ian Read said when announcing the increases that “the best means to address affordability of medicines is to reduce the growing out-of-pocket costs that consumers are facing due to high deductibles and co-insurance”, which is another of Trump’s proposals.

Ian Read

Ian Read, Pfizer CEO

There’s a gulf between the tabling of a bill and getting it through the House and Senate and plenty of opportunity for the price control proposals to be watered down. However, the unusual alignment on reference pricing as the means to that end suggests that bipartisan support can’t be ruled out.

The pharma industry strongly resists setting prices to an overseas index, saying it would penalise the companies who bring innovative drugs to market and set the US on a par with countries that discourage innovation and restrict access to new medicines.

“Today we’re sending big pharma a message: market exclusivity is a privilege, and when you abuse that by price gouging the sick and aging, then you lose that privilege,” said Khanna.

“This bill will bring down drug prices by taking on monopolies and boosting prescription drug competition.”

Phil Taylor
21st November 2018
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