Sunday October 20, 2019

Nancy Pelosi Unveils Ambitious Plan to Lower Drug Prices for Seniors on Medicare

Pharmaceutical companies that refuse to negotiate could face steep penalties

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Speaker of the House Nancy Pelosi, D-Calif., arrives for a gathering of the House Democratic Caucus at the Capitol in Washington, Sept. 10, 2019. VOA

Putting her stamp on the health care issue that worries consumers the most, House Speaker Nancy Pelosi on Thursday unveiled an ambitious plan to lower drug prices for seniors on Medicare and younger people with private insurance.

Pelosi, D-Calif., would empower Medicare to negotiate prices for the 250 costliest drugs, including insulin. Pharmaceutical companies that refuse to negotiate could face steep penalties. Additionally, drugmakers that hike prices beyond inflation would have to pay rebates to Medicare.

The plan would limit copays for seniors covered by Medicare’s “Part D” prescription drug program to $2,000. And Medicare-negotiated prices would be available to other buyers, such as employer health plans.

The plan is Pelosi’s marker in what’s shaping up as a high-stakes negotiation to determine if a drug pricing compromise can pass Congress this year or if Democrats and Republicans will take their differences into the 2020 elections.

Nancy Pelosi, Plan, Drug
Putting her stamp on the health care issue that worries consumers the most, House Speaker Nancy Pelosi on Thursday unveiled an ambitious plan to lower drug prices. Pixabay

The sweeping legislation leans left politically and appears to be tailor-made for Pelosi’s Democratic majority in the House. But in a signal that Pelosi wants a deal, it also incorporates ideas from the Trump administration and from Republican and Democratic senators.

A solid majority of Americans, regardless of partisan affiliation, says lowering prescription drug costs should be a top priority for Congress this year. Overall, 70 percent deemed that a top priority in a poll earlier this month from the nonpartisan Kaiser Family Foundation.

President Donald Trump appears eager to sign prescription drug legislation and lower costs, but most Republicans oppose the Medicare negotiations that are the centerpiece of Pelosi’s plan. The 2003 law that created Medicare’s prescription drug benefit barred the program from negotiating prices, a restriction Democrats have long opposed.

As a candidate, Trump backed Medicare negotiations. But after Trump was elected president, he seemed to revert to the traditional Republican position that price negotiations are best left to private players like insurance companies.

With tens of billions of dollars in profits at stake, drugmakers are determined to block any major changes to payment policies. But the industry’s powerful lobbying group, the Pharmaceutical Research and Manufacturers of America, has been taking fire from all sides, from liberal Democrats to pro-business Republicans. Trump once accused drug companies of “getting away with murder.”

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Pelosi’s proposal would:

► Authorize Medicare to negotiate prices for the drugs with the greatest total cost to the program and the U.S. health care system. That includes pharmacy drugs covered through the popular “Part D” prescription benefit, along with “Part B” medications dispensed in doctors’ offices, a category that covers many cancer drugs. The maximum price would be determined using a blend of international prices, an idea similar to a more limited proposal from the Trump administration. Insulin prices would be subject to negotiations. Drug companies that balk at making a deal would face penalties that start at 65% of sales for the drug at issue and would escalate if they hold out.

► Require drugmakers to pay rebates to Medicare if they hike their prices beyond the increase in inflation. That idea resembles a bipartisan plan from Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore. The senators’ proposal has already cleared a key committee, with Trump’s support. But many Senate Republicans oppose inflation rebates, and it’s unclear what Majority Leader Mitch McConnell, R-Ky., plans to do next.

► Limit what seniors pay out of pocket for their medications to $2,000 a year. Currently, Medicare’s pharmacy benefit has no cap on copays, and the advent of drugs costing hundreds of thousands of dollars a year has left some seniors saddled with bills that rival a mortgage payment. An out-of-pocket limit also is part of the Grassley-Wyden bill, and the idea also is backed by the Trump administration.

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Pelosi, D-Calif., would empower Medicare to negotiate prices for the 250 costliest drugs, including insulin. Pixabay

Pelosi’s office says her plan is to have the legislation introduced and moved through House committees to a vote on the floor. If compromise can be reached among House Democrats, the Trump White House and lawmakers in the Senate, a drug pricing package could be added to year-end budget legislation.

Movement in Congress comes at a time when criticism of the industry – from Trump and lawmakers of both parties – appears to be having an effect on prices.

The Commerce Department’s inflation index for prescription drug prices has declined in seven of the last eight months, which is highly unusual. That index includes lower-cost generic drugs.

The story is different for brand name drugs, however. A recent analysis by The Associated Press shows that on average prices are still going up but at a slower pace. The cost of brand name drugs is most concerning to consumers, because it translates to steep copays for insured patients.

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The AP analysis found that in the first seven months of 2019, drugmakers raised list prices for brand name medicines by a median, or midpoint, of 5%.

That does reflect a slowdown. Prices were going up 9% or 10% over those months the prior four years.

But there were 37 price increases for every decrease in the first seven months of 2019.

Pricing data for the AP analysis came from the health information firm Elsevier. (VOA)

Next Story

Venice Presents Plan to Tackle Effects of Climate Change

The ones who hurt it those who spend only one day," Luigi Brugnaro, Venice's Mayor told Efe in an interview

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Anyone has to visit Venice with respect. You have to go for a few days, to be impregnated with it. Pixabay

In a bid to save its heritage, the Italian city of Venice has presented a plan to tackle the effects of climate change, calling for responsible tourism at this years C40 World Mayors Summit in Copenhagen.

For years, Venice has been facing its toughest challenge ever: the risk of flooding due to rising sea levels, Efe news reported on Saturday.

However, authorities warn that mass tourism and its environmental impact have also become a challenge for the city, a cradle of history dating back more 1,500 years.

“Anyone has to visit Venice with respect. You have to go for a few days, to be impregnated with it. The ones who hurt it those who spend only one day,” Luigi Brugnaro, Venice’s Mayor told Efe in an interview.

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For years, Venice has been facing its toughest challenge ever: the risk of flooding due to rising sea levels, Efe news reported on Saturday. Pixabay

The conservative politician took part in the C40 World Mayors Summit in Copenhagen, where he unveiled his plan to protect the Italian city from the effects of global warming.

His medium and long-term roadmap includes policies affecting not only the huge cruise ships that enter Venice daily but also the 25 million people that visit the city every year.

“No one should have negative thoughts about tourists. They are curious people who want to see a place like Venice and it is fair that they can do it. We only have to establish simple rules,” Brugnaro said.

From January 2020, visitors who spend less than 24 hours in Venice will have to pay a tourist tax of 10 euros to offset cleaning and maintenance costs.

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Brugnaro also plans to regulate tourist rentals through platforms such as Airbnb.

In Venice, door-to-door garbage collecting has increased recycling. However, many visitors were not aware of the existence of this service.

Venice and its lagoon were declared a Unesco World Heritage Site in 1987, but two years ago the UN organization warned the Italian city that it should take steps before 2021 to avoid being included in his “blacklist”.

The next meeting of the UN committee to monitor the progress will be held in China in 2020.

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However, authorities warn that mass tourism and its environmental impact have also become a challenge for the city, a cradle of history dating back more 1,500 years. Pixabay

Venice goes on alert when a high tide reaches 80 cm. If sea-levels were to rise by 110 cm, more than 10 per cent of the pedestrian area of the historic centre would be flooded.

If the worst predictions of the Intergovernmental Panel on Climate Change (IPCC) are fulfilled, according to which the sea level could rise 110 cm in 2100, the situation could become critical.

“It is not inevitable that it will end up being destroyed. Venice is much more alive than some say. It is a resilient city that adapts,” the Mayor told Efe news.

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The city is “a symbol for the world, one of its greatest symbols. We must set aside our selfishness and interests. If Venice is saved, the world is saved”, he added. (IANS)