When President Donald Trump rolled out an ambitious pilot program to lower the costs of physician-administered drugs in late October, policy experts expected the same swift condemnation Congress and the health care industry directed at former President Barack Obama’s Part B demonstration plan. But so far, at least, the outrage hasn’t been nearly as loud.
“When we saw the Medicare Part B demonstration that was put out by the last administration, there were definitely a lot more stakeholders coming to the Hill with concerns than there are right now with this Medicare Part B proposal,” Rita Habib, health policy adviser to Sen. Michael Bennet (D-Colo.), told the Prevision Policy and Friends of Cancer Research Biopharma Congress last week.
Lauren Fleming Paulos, health legislative assistant to Sen. Orrin Hatch (R-Utah), agreed that she hasn’t seen “as much stakeholder involvement” but added that there are still similar concerns on the hill, with “members that are skeptical.”
Criticisms of Obama’s plan came from both sides of the aisle as well as the drug industry, and doctor and patient groups. Among the concerns: Patients might lose access to needed drugs, and the demonstration plan was too large for a pilot program that lacked congressional approval. It died in late 2016 amid widespread belief that the incoming administration would never embrace it. The Trump administration’s proposed rule is expected in early 2019.
Few lawmakers have publicly criticized the demo. Rep. Larry Bucshon (R-Ind.), one of the only Republicans to outwardly condemn it, told The Hill on Friday that Trump’s proposal to more closely tie Part B drug payments to other countries’ rates is a move toward “price controls.”
Democrats have largely embraced the plan while signaling that it doesn’t go far enough. The pilot does not require congressional approval, but opposition could make it harder for the administration to proceed.
Senate is still a barrier: The muted pushback to date doesn’t mean it will be easy to get drug pricing proposals that do require congressional approval through the Republican-controlled Senate. “When it really comes down to passing something, it will be challenging,” Habib said.
“I don’t think it’s going to be that easy,” Paulos added. “I think there is still some nervousness among Republicans with the drug pricing blueprint. I think they are still looking at it and considering it, but there is definitely a little unease.”
One wild card: Incoming Senate Finance Chairman Chuck Grassley (R-Iowa) is one of the most vocal Republican critics of the drug industry. Pros can read more about his record on pharma issues here.