House members will get their first chance this week to weigh in on Speaker Nancy Pelosi's drug pricing legislation — a hearing where Democrats are expected to not only clash with Republicans but also potentially with members of their own party.
The House Energy and Commerce Health Subcommittee will also use the Sept. 25 hearing to vet three other bills focused on lowering drug costs for Medicare beneficiaries through direct negotiations between the government and manufacturers.
Senate Republican leaders have already said there was no pathway to success for Pelosi's bill in that chamber.
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"The speaker's plan is just the latest example of a partisan messaging document masquerading as legislation and it has absolutely no chance — zero, zip, nada — of passing the Senate or becoming law," Sen. John Cornyn, R-Texas, said on the Senate floor on Sept. 19 shortly after Pelosi revealed the details of her bill.
Cornyn echoed comments from drug industry lobbyists that the various Democratic proposals to let the government negotiate drug prices "puts us on a path to socialized medicine."
President Donald Trump, however, showed some support for the speaker's legislation, tweeting that "it's great to see Speaker Pelosi's bill today. Let's get it done in a bipartisan way!"
Pelosi's legislation reaches far more broadly than any of the Trump administration's proposals and also would do more to lower drug prices and protect patients from high out-of-pocket costs than the legislation adopted in July by the Senate Finance Committee, said Rachel Sachs, associate professor of law at Washington University in St. Louis.
With time running out for Trump to achieve anything on his own in reducing Americans' drug costs, he may seek to back one or both congressional reform packages, Sachs wrote in a Sept. 19 article in the public policy journal Health Affairs.
In addition to Pelosi's package, the Energy and Commerce Health Subcommittee will also review three bills from Democratic Reps. Lloyd Doggett of Texas, Elijah Cummings of Maryland and Peter Welch of Vermont, who partnered with Republican Rep. Francis Rooney of Florida.
Doggett's bill, H.R. 1046, would give the secretary of health and human services the power to negotiate the prices of all drugs covered under the Medicare Part D program while taking into account certain factors.
Under Cummings legislation, H.R. 448, if the HHS secretary is not successful in obtaining an appropriate price for an applicable covered Part D medicine during negotiations with the manufacturer, the price charged to drug plans would be the lowest of three options.
The bipartisan bill from Welch and Rooney, H.R. 275, would give HHS the authority to negotiate drug prices for Medicare, but would not give the agency the power to establish or require a particular formulary or affect its authority to ensure plan compliance with the existing Part D formulary requirements.
House panel probes equity companies
Meanwhile, the Democratic and Republican leaders of the House Energy and Commerce Committee opened an investigation last week into the role private equity companies are playing in the surprise medical bills that are increasingly hitting Americans with unexpected high out-of-pocket costs.
The companies have also been behind advertisements opposing House and Senate legislation aimed at reining in the surprise medical bills.
Last week, the Congressional Budget Office said the House's No Surprise Act would reduce commercial insurance premiums by 1% and save U.S. taxpayers about $22 billion over a decade.
But if an arbitration appeal process was used, those savings would be cut by 25%.
FDA tech modernization plan
The U.S. Food and Drug Administration on Sept. 18 unveiled its much-anticipated action plan aimed at modernizing the technology it uses in its regulatory processes, like moving its data exchange capabilities to virtual storage systems, or the cloud.
The plan is intended to help the FDA close the gap between the latest scientific and biomedical advances from industry, like cell and gene therapies, and the somewhat out-of-date technologies and analytics the agency uses to review the data in product marketing applications.
FDA, NIH spending boosts
Also last week, the Senate Appropriations Committee approved $5.76 billion in total spending for fiscal 2020 for the FDA — nearly $3.15 billion in discretionary taxpayer funds and $2.61 billion in industry user fees.
If adopted by Congress, the measure would provide the FDA an increase of $80 million in discretionary funds and $180 million in user fees over the agency's current funding level.
A separate Senate Appropriations bill that would provide the U.S. National Institutes of Health with $42.1 billion — an increase of $3 billion — has gotten bogged down in a political dispute involving the Title X family planning program.

House Speaker Nancy Pelosi