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To Tame Prescription Prices, HHS Dips A Toe Into Drug Importation Stream

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It got here as one thing of a shock when Health and Human Services Secretary Alex Azar introduced that the administration was exploring the importation of prescription drugs to combat excessive home costs. Azar and Scott Gottlieb, commissioner of the Food and Drug Administration, who also endorsed the brand new proposal, had beforehand opposed the thought.

But drug costs within the U.S. have continued to rise and greater than 80 p.c of Americans say the federal government ought to take motion. President Donald Trump has stated drugmakers are “getting away with murder” and has angrily tweeted at companies about particular person value hikes.

Although the candidate Trump supported the thought of permitting sufferers to import medicines, since he was elected he has not talked about that choice — which is strongly opposed by drug firms.

Now, decided to discover extra avenues to curb value hikes, the administration is signaling that it’s keen to contemplate what the trade regards as one thing of a nuclear choice to deal with a recalcitrant drawback. Carefully tailor-made to focus solely on particular conditions the place a high-priced drug is made by one firm, it’s discovering assist the place broader proposals have failed.

“They’re approaching it incrementally and wisely, they’re focusing on prices where there’s a need,” stated Dan Mendelson, the founding father of well being care advisor firm Avalere and an official within the Clinton White House. “It is certainly more narrow than the way others have conceptualized it.”

Far from a blanket legalization of imported medicines, the working group Azar convened will research importation to fight sudden value will increase in particular medication. The focus is on briefly bringing in cheaper comparable or similar medication to introduce competitors into the U.S. market. The medicines should be off-patent and have just one producer right here.

Azar’s memo stated the trouble is designed to keep away from the form of in a single day will increase seen with Daraprim in 2015. That price hike was engineered by “pharma bro” Martin Shkreli, then CEO of Turing Pharmaceuticals. He bought the rights to the single-sourced remedy that treats parasitic infections and started charging $750 for a capsule that previously price $13.50 and prices somewhat greater than a greenback in a lot of the world. Turing was the one U.S. producer.

“This is a workable solution to a discrete problem,” stated Ameet Sarpatwari, an teacher in drugs at Harvard Medical School in Boston.

But those that assist extra sweeping importation insurance policies decried the plan’s restricted scope and suspected the announcement was half theatrics and half a threatening sign to drugmakers.

“This could just be a dog-and-pony show, where they’re calling in an expert group to explore avenues of importation — but when all is said and done, they find that they don’t want to do this,” stated Gabriel Levitt, the co-founder of PharmacyChecker.com, a personal firm that verifies worldwide on-line pharmacies and compares prescription drug costs for customers.

“At that point, we’ll learn that the exercise was lip service,” he added. “Frankly, there’s a good chance that that is the case.”

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This isn’t the first time officers have steered importing medication from different nations to search out higher costs. Bills have been provided in Congress to permit it, and George W. Bush administration officers investigated the difficulty and produced two reports questioning the protection of such efforts in 2004.

Overall, the measure is under no circumstances a silver bullet to the bigger drawback of rising drug costs, stated Rachel Sachs, an affiliate professor of regulation at Washington University School of Law in St. Louis.

“It’s a really smart move to solve one of the many drug pricing problems we observe, but, of course, it won’t address every problem,” Sachs stated.

Mendelson steered this working group may be an effort to placate sufferers who’ve seen little motion to deliver down drug prices, regardless of the president’s repeated guarantees to supply assist.

“If the goal is to make policy changes that are visible and help with the 2018 and 2020 election, I think it’s right up there with a lot of the things they’re doing,” Mendelson stated. “If the goal is truly to help consumers with drug prices, not so much.”

In addition, because the group’s work applies primarily to the generic drug market, a brand new coverage would cease wanting taming the value spirals and excessive launch costs of blockbuster brand-name medication, which Harvard’s Sarpatwari stated have been the “elephants in the room” of the drug pricing debate.

Levitt identified that whereas an enormous in a single day enhance on a drug would possibly set off motion to permit importation, the transfer would do nothing to cease the yearly will increase that drug firms tack on to medicines. Depending on how potential rules are written, such will increase would possibly even be inspired. The administration has been pressuring pharmaceutical makers to carry down these rising costs however discovering tepid support among the companies.

Even if the coverage targets only a slice of the general drawback, it may nonetheless make a distinction for Americans struggling to pay for off-patent medication and supply extra competitors.

“If Azar is serious about this proposal, even though it’s very limited in scope, it could help deter the most egregious forms of drug price gouging where there are single-source meds,” Levitt stated.

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KHN’s protection of prescription drug improvement, prices and pricing is supported partially by the Laura and John Arnold Foundation.

Rachel Bluth: rbluth@kff.org”>rbluth@kff.org, @RachelHBluth

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