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May 31 — Concerns over prescription drug pricing can be a significant advantage for Democrats in the general election, but the candidates will need to keep calling attention to the issue if they don't want it to be drowned out, a prominent lawmaker said.
“I expect it will play a significant role, but I think it’s going to be one that the Democrats will have to raise,” Rep. Elijah Cummings (D-Md.) told Bloomberg BNA in a recent interview. Cummings is the chairman of the committee that will help craft the official Democratic Party platform ahead of the national convention this summer. He has worked with Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) to craft legislation to regulate drug prices, and noted that both Sanders and his Democratic competitor, Hillary Clinton, view drug pricing as a priority.
“It’s the No. 1 issue for Democrats, Republicans and independents. It’s the No. 1 health issue,” Cummings said. “So it would not surprise me to see it [in the platform].”
Rising prescription drug prices are stoking voters' anger this election cycle as new, highly expensive medications are hitting the market while the prices of some older drugs—like Turing Pharmaceuticals' Daraprim—are skyrocketing. Federal data show drug spending rose substantially in 2014, after four years of static to modest growth.
“It affects just about everybody. Somebody has a neighbor or friend who’s seen the prices of their prescription drugs skyrocket, or their copays,” Cummings said.
A Democratic lobbyist told Bloomberg BNA campaigns like to focus on the easy targets of populist outrage—the pharmaceutical industry for rising drug prices, and insurance companies for high premiums.
“Drug companies are a convenient target,” the lobbyist said. “They're being used by Democrats and some Republicans as an example of an inflationary problem in the health-care system.”
Unlike other policy positions, both Sanders and Clinton have released specific plans on how they'd address rising drug prices. They can also use the issue as a way to pivot from some of the unpopular aspects of the Affordable Care Act.
“Democrats have pointed to drug prices on the campaign trail as a way to talk about health care and pocketbook issues that don’t relate directly to the ACA,” Elizabeth Carpenter, vice president at consulting group Avalere Health, told Bloomberg BNA. The issue is “likely to come up not just in health care, but in conversations about kitchen table issues, pocketbook issues. This may be a topic that spans economic and health-care discussions.”
Both Clinton and Sanders want the government to have the power to negotiate drug prices for Medicare beneficiaries. Medicare currently doesn't have that authority—it was banned when Part D was added to the Medicare program in a 2003 law. The Congressional Budget Office has declined to score any proposals, and has said lifting the ban “would have a negligible effect” on cost.
Both of the Democratic presidential campaigns also want to require drug companies to offer minimum rebates off the sticker price in order to participate in Medicare, at least for lower-income beneficiaries.
Sanders and Clinton both have proposed importing drugs. One key obstacle to importation has been the inability to assure the quality of drugs, and federal officials in administrations going back to Bill Clinton's have warned against the policy. Both candidates also want to prohibit “pay-for-delay” patent litigation settlements between brand and generic drugmakers. These are deals in which drugmakers with patents that are nearing expiration pay companies to delay the introduction of a generic version of their drug.
Democratic strategist Brad Bannon said Democrats can use the drug pricing issue more effectively than Republicans.
“Republicans could say ‘let the market deal with it,' which would not make voters happy,” Bannon told Bloomberg BNA. “Pharmaceutical companies are incredibly unpopular. Democrats should say the government should put limits on the pricing of drugs.”
Republicans have generally tended to stay out of the prescription drug pricing debate, aside from general criticisms of drug companies or government regulations. But presumptive Republican nominee Donald Trump has split from the party's standard view. Trump has said he wants the government to negotiate drug prices, and has also called for importing cheaper drugs from foreign countries—which until now primarily have been Democratic ideas.
“Trump being the nominee creates an interesting dynamic,” Carpenter said. Since all candidates have similar views, it's possible their policies may evolve based on what the other candidate does. “We'll see if both nominees feed off each other,” Carpenter said.
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