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Democrats seek to speed drug pricing bill to House floor; CMS chief to testify

The U.S. House Ways and Means Committee will markup Speaker Nancy Pelosi's drug pricing bill at an Oct. 22 session, the last of three panels to vet the legislation before Democrats move it to the House floor for a vote.

"Americans have been demanding action on rising prescription drug prices for years," Ways and Means Committee Chairman Richard Neal, D-Mass., said late last week.

SNL ImageWays and Means Committee Chairman Richard Neal, D-Mass., and Rep. Tom Reed, R-N.Y.
Source: AP Photo

On Oct. 17, the House Energy and Commerce and Education and Labor Committees held markup sessions of their own, where only some tweaks were made to the legislation, despite Republicans' attempts to make significant changes.

The legislation, known as H.R. 3, will bear House Oversight and Reform Committee Chairman Elijah Cummings' name. Cummings, D-Md., died on Oct. 17 after experiencing longstanding health challenges.

The bill would allow the federal government to set a maximum price on as many as 250 drugs that lack competition in the U.S., with Medicare beneficiaries paying no more than $2,000 out of pocket each year for their medicines.

Under H.R. 3, the government would rely on prices set by foreign nations to gauge what the U.S. would pay for its medicines — a provision that mirrors a pending proposal from the Trump administration.

If a manufacturer refused to participate in any part of the negotiation process or does not reach agreement on a price, the company would be charged an escalating penalty based on the drug's gross sales, starting at 65% and rising 10% every quarter the drugmaker is out of compliance, to a maximum of 95%.

Pelosi wants to bring the bill to the House floor the last week of October for a vote.

Republicans and some Democrats, including Rep. Lloyd Doggett, D-Texas, chairman of the Ways and Means Health Subcommittee, are expected to try to make further changes to the bill.

Doggett wants to up the number of drugs negotiated under the bill.

Industry opposition

Drug lobbyists have strongly opposed the legislation.

The process that the Pelosi bill would use to hammer out prices with drugmakers is "not negotiation," Pharmaceutical Research and Manufacturers of America President and CEO Stephen Ubl argued in an Oct. 17 op-ed in Stat News.

Republicans at the Oct. 17 House markup sessions made similar arguments, saying the Pelosi bill does not give drugmakers equal bargaining power.

SNL ImagePhRMA President and CEO Stephen Ubl
Source: AP Photo

PhRMA has insisted H.R 3 would harm innovation — an argument the lobbying group has been making in a TV commercial over the past few months.

"If Washington isn't careful, we might leave innovation behind," a patient with multiple sclerosis says in the PhRMA ad.

But a recent study by researchers at the University of Pittsburgh found that price increases for multiple sclerosis drugs have been some of the sharpest, including for the older medicines, like Biogen Inc.'s Avonex and Teva Pharmaceutical Industries Ltd.'s Copaxone, which were both first approved in 1996.

From 2006 to 2016, prices for multiple sclerosis drugs quadrupled, ballooning from about $18,000 to nearly $76,000 per patient per year, the researchers reported in late August.

Their analysis also found that out-of-pocket costs for multiple sclerosis medicines rose more than sevenfold for Medicare Part D beneficiaries.

The high costs of medicines is also a "major problem" faced by cancer patients, said Richard Pazdur, director of the U.S. Food and Drug Administration's Oncology Center of Excellence.

"I don't think anyone has the answer to this," Pazdur said at an Oct. 17 forum hosted by the Washington Post.

He emphasized, however, that the FDA was "agnostic" on drug prices when it comes to evaluating new medicines for the U.S. market.

SNL ImageEnergy and Commerce Chairman Frank Pallone, D-N.J.
Source: AP Photo

CMS chief called to testify on ACA

Meanwhile, the House Energy and Commerce Oversight and Investigations Subcommittee has called on Centers for Medicare and Medicaid Services Administrator Seema Verma to testify at an Oct. 23 hearing about what Democrats have said are the Trump administration's efforts to undermine the Affordable Care Act.

Verma has "played a key role in the Trump administration's ongoing efforts to sabotage Americans' health care while flouting our congressional oversight requests," Reps. Frank Pallone, D-N.J., chairman of the Energy and Commerce Committee, and Diana DeGette, D-Colo., head of the Oversight and Investigations Subcommittee, said in an Oct. 16 statement.

Pallone said the administration has refused to turn over documents and information that he and other House Democratic leaders have been seeking since June.

In an Oct. 16 letter, he called on Verma and Health and Human Services Secretary Alex Azar to provide that information by Oct. 30.

The documents Pallone is seeking includes internal assessments by CMS's Office of the Actuary on a number of Trump administration policy proposals under consideration, which the New Jersey Democrat said would result in over 1 million Americans losing healthcare coverage and increased premiums for other people in the U.S. if implemented.