Parting Words From A Health Policy Veteran

January 3, 2019 9:25 am

Members of the 116th Congress were sworn into office this week and, as dozens of news outlets reported over the holiday, the issue of drug prices will be on lawmakers’ agenda (not to mention in the stump speeches of every candidate running for the White House in 2020).


One veteran lawmaker will no longer be on Capitol Hill this January and, as freshmen members assemble, it’s worth highlighting his departing advice to colleagues.


In a letter dated Dec. 19, Sen. Orrin Hatch (Utah) – who served in the U.S. Senate for more than 40 years (Medicare was just a decade old when Hatch was first elected) and as chairman of the powerful Finance Committee for four years – shared his thoughts on how to balance questions of pharmaceutical innovation and cost. Calling the matter of drug prices a “touchstone of [his] career,” Sen. Hatch called on his colleagues to preserve the “underlying market-based principles” of the current system and resist government intervention. 


Specifically, the now-retired senator said lawmakers should resist the Trump administration’s proposal to adopt the International Pricing Index (IPI) model for Medicare. Hatch warned the proposal, which the administration advanced in October, would “dampen research and development – depriving patients of future treatment breakthroughs and further eroding necessary competition.”


Many patient advocacy groups agree.


In early December, a group of 340 medical associations, patient advocacy groups, and others submitted a letter to members of Congress asking them to block IPI implementation. They argued the proposal would:


  • Impose decisions made in other countries on approximately half of all independent physicians and hospital providers in the United States and their patients.
  • Interject new middlemen between physicians and patients who would impose requirements dictating treatment for patients with cancer, autoimmune disorders, and other life-threatening conditions.
  • Restrict access in the short-term, and reduce incentives for medical advancement in the long-term beneficiaries.


Patient groups followed that communication with individual letters submitted to Centers for Medicare and Medicaid Services (CMS). Most of these comments argued the proposal would reduce the types of treatment available to patients. For example, the American College of Rheumatology said, IPI “could restrict patient access to care.”


Organizations representing hospitals also raised concerns. In its CMS comment letter, the Federation of American Hospitals argued IPI would be highly disruptive and burdensome for hospitals and physicians forced to participate. The organization also cautioned the proposal “may increase international prices rather than lower U.S. drug prices and potentially increase U.S. prices for physicians and hospitals ...”


In that final letter to colleagues, Orrin Hatch said lawmakers should strive to enact policies that achieve “meaningful changes that improve the lives of patients.” For him, and for millions of patients throughout the United States, that means rejecting IPI. Members of the 116th Congress should listen.