Drug Costs

A Look Beyond 2020

March 6, 2020 12:05 pm

Watching the changes happening in the Election 2020 landscape over the last week has been a little bit like watching the stock market—take your eyes off the ticker for a few minutes and you’re likely to miss a big shift in momentum.


With the field changing so quickly, we thought it would be a good time to look at what the candidates and the incumbent they are trying to unseat have proposed when it comes to pharmaceutical prices and innovation. And while we will refrain from making judgements on those specific proposals in this post, we will point you to previous posts on similar issues or ideas. Let’s get started.


President Donald Trump


Using his regulatory powers, the Trump administration has offered plans to:

- Allow certain pharmaceuticals to be imported from Canada.

- Create a new Medicare pricing model, the International Pricing Index (IPI), which would tie Medicare drug costs to prices paid in foreign countries. (Not sure what the IPI is? We’ve got all you need to know here, here, and here.)

- Allow Medicare Part D permit health insurance companies to stop covering certain “protected” classes of drugs used to treat common ailments.


According to a report from Bloomberg, President Trump also is considering an executive order that would “force drug companies to accept lower payments from Medicare for treatments administered in doctors’ offices.”


President Trump also has said he wants to end HIV and AIDS in America. As we explain here, achieving that goal would be impossible while capping drug prices.


Former Vice President Joe Biden


Former Vice President Biden unveiled his drug-pricing plan last July. According to BioSpace, Biden would:

- Allow Medicare to negotiate with drug companies.

- Limit prices for new drugs.

- Creation of an independent review board to assess the value of a new drug. (An “independent” board like the Institute for Clinical and Economic Review? Check out how that works—and who it listens to.)

- Allow drug importation. (Click here to read our latest on that issue.)

- Limit price increases on branded drugs and generics for drugs included in Medicare.

- End tax deductions to pharmaceutical companies.


Sen. Bernie Sanders


On his campaign website, Sen. Sanders pledges to ensure “no one in America pays over $200 a year for the medicine they need by capping what Americans pay for prescription drugs under Medicare for All.” We will leave the debate over Medicare for All to other organizations.


During the 114th Congress, Sen. Sanders introduced legislation that would allow the Department of Health and Human Services to negotiate drug prices with pharmaceutical companies, allow drug importation from Canada (here’s more on that issue), impose new penalties for drug companies that commit fraud, and require drug companies to disclose the total costs of research and development and clinical trials.


This year, Sen. Sanders has supported legislation that, according to CNBC, would “peg the price of prescription drugs in the U.S. to the median price in five major countries — Canada, the United Kingdom, France, Germany and Japan.” He also has tried to advance a bill that would create an entirely new federal agency to oversee pharmaceutical pricing. According to The Hill, that legislation contains elements of previous bills Sen. Sanders has supported, including requiring drug companies to disclose research and development (R&D) costs. (To be clear, we already know how much the industry pays. As we have explained here, the biopharmaceutical sector invests more in R&D than any other industry, plowing more than 18 percent of its overall revenue into developing new medicines.)


The political debate this year has been filled with errors (review our fact-checking here), and what none of these candidates will talk about is the drastic unintended consequences that would follow from their proposals.


Stay tuned—because we will continue to do just that.