Policy, Payers

Trump once again favors allowing Medicare to negotiate drug prices

This represents the president’s second change of opinion on the matter in the last week.

WASHINGTON, DC - FEBRUARY 3: President Donald Trump speaks to business leaders during a strategy and policy forum in the State Dining Room of the White House in Washington, DC on Friday, Feb. 03, 2017. (Photo by Jabin Botsford/The Washington Post via Getty Images)

President Donald Trump speaks to business leaders during a strategy and policy forum in the State Dining Room of the White House Feb. 3.

Say this about the new Trump administration: It’s keeping people on their toes.

Tuesday, White House spokesman Sean Spicer said that President Donald Trump is in favor of giving the Centers for Medicare and Medicaid Services the authority to negotiate drug prices under the Medicare Part D pharmacy benefit.

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“He’s for it,” Spicer said at his daily press briefing in Washington, according to Reuters. Spicer added that Trump would apply his “skills as a businessman” to rein in drug spending.

This represents another position change.

During the presidential transition period, Trump hammered away at the pharmaceutical industry, saying that Big Pharma was “getting away with murder.” In a Jan. 11 press conference, Trump offered the following, with the usual bluster:

Pharma has a lot of lobbies, a lot of lobbyists and a lot of power. And there’s very little billeting on drugs. We’re the largest buyer of drugs in the world, and yet we don’t bid properly. And we’re going to start bidding and were going to save billions of dollars over a period of time.

But last week, when seven pharma execs were with him at the White House, Trump appeared to reverse course. Because those rich guys with him have, you know, a lot of power, as a certain rich guy had said a few weeks earlier.

Rather than insisting he would use his negotiating acumen to drive prices down, Trump called on the rest of the world to stop relying on the United States to subsidize drug discovery.

“We’re going to be ending global freeloading,” Trump said at that Jan. 31 meeting. “Foreign price controls reduce the resources of American drug companies to finance drug and R&D innovation. I think you people know that very well. It’s very unfair to this country.”

Trump also apparently indicated that he was opposed to the federal government negotiating drug prices.

“I’ll oppose anything that makes it harder for smaller, younger companies to take the risk of bringing their product to a vibrantly competitive market,” Trump said, according to the left-leaning Slate. “That includes price-fixing by the biggest dog in the market, Medicare, which is what’s happening. But we can increase competition and bidding wars, big time.”

He, of course, did not offer specifics. Because Trump. But he did say that he would cut taxes and planned on “getting rid of regulations that are unnecessary.”

Nor did Trump mention that the federal government already negotiates drug prices via the Veterans Health Administration, the Military Health System and the Indian Health Service. Medicaid requires drug suppliers to provide rebates when prices exceed certain thresholds.

Let’s see if this new-old position changes again when Big Pharma unleashes its army of lobbyists on Congress.

CMS spent about $76 billion on Part D, or $2,203 per beneficiary, in 2015. That accounted for 12 percent of all Medicare spending.

Photo: Jabin Botsford/The Washington Post via Getty Images