Few teeth in Trump's prescription to reduce drug prices

WASHINGTON -- President Donald Trump's long-promised plan to bring down drug prices, unveiled Friday, would mostly spare the pharmaceutical industry he previously accused of "getting away with murder." Instead he focuses on private competition and more openness to reduce America's prescription pain.

In Rose Garden remarks at the White House, Trump called his plan the "most sweeping action in history to lower the price of prescription drugs for the American people." But it does not include his campaign pledge to use the massive buying power of the government's Medicare program to directly negotiate lower prices for seniors.

That idea has long been supported by Democrats but is a non-starter for drugmakers and most Republicans in Congress. Democratic Rep. Lloyd Doggett of Texas dismissed Trump's plan as "a sugar-coated nothing pill."

The administration will pursue a raft of old and new measures intended to improve competition and transparency in the notoriously complex drug pricing system. But most of the measures could take months or years to implement, and none would stop drugmakers from setting sky-high initial prices.

"There are some things in this set of proposals that can move us in the direction of lower prices for some people," said David Mitchell, founder of Patients for Affordable Drugs. "At the same time, it is not clear at all how they are going to lower list prices."

Drugmakers generally can charge as much as the market will bear because the U.S. government doesn't regulate medicine prices, unlike most other developed countries.

Trump's list of 50 proposals, dubbed American Patients First, includes:

• A potential requirement for drugmakers to disclose the cost of their medicines in television advertisements.
• Banning a pharmacist "gag rule," which prevents druggists from telling customers when they can save money by paying cash instead of using their insurance.
• Speeding up the approval process for over-the-counter medications so people can buy more drugs without prescriptions.
• Reconsidering how Medicare pays for some high-priced drugs administered at doctors' offices.

Those ideas avoid a direct confrontation with the powerful pharmaceutical lobby, but they may also underwhelm Americans seeking relief from escalating prescription costs.

Democrats pounced on Trump for not pursuing direct Medicare negotiations, an idea he championed before reaching the White House.

"This weak plan abandons the millions of hard-working families struggling with the crisis of surging drug prices," said Democratic Leader Nancy Pelosi, in a statement.

Pharmaceutical investors and analysts expressed relief after the announcement, and shares of most top drugmakers rose Friday afternoon, including Pfizer, Johnson & Johnson and Eli Lilly.

"Trump had a choice today: to seek disruptive fundamental reform or to embrace more incremental steps," wrote Terry Haines, a financial analyst, in an investment note. "Trump chose the incremental over the disruptive."

Some parts of the plan were previously proposed in the president's budget proposal sent to Congress, including providing free generic drugs to low-income seniors and sharing rebates from drugmakers with Medicare patients. Other parts could be implemented directly by the administration.

A majority of Americans say passing laws to bring down prescription drug prices should be a top priority for Trump and Congress, according to recent polling by the Kaiser Family Foundation.

As a candidate, Trump railed against the pharmaceutical industry. But as president he has shied away from major changes and has staffed his administration with appointees who have deep ties to the industry. They include Health Secretary Alex Azar, a former top executive at Eli Lilly and Co., who joined Trump for Friday's announcement.