According to a study by RAND Health Care, prices for all medications in the United States in 2022 were nearly 2.78 times higher than prices in comparable countries. (Photo by JGI/Jamie Grill/Getty Images)
“With this bill (House Bill 2263), West Virginia will lead the country in lowering prescription drug prices…I am honored to do my part to sign this bill into law so we can help thousands of West Virginians afford prescription drugs.” – Then Governor Jim Justice (2021)
Gov. Jim Justice pushed for lower drug prices as governor. Now that he can actually do something about it by proposing national laws to codify MFN pricing (see below), we’re not hearing anything anymore. Similarly, Senator Shelley Moore Capito has called on Congress to regulate Pharmacy Benefit Managers – but has not pushed for MFN pricing.
Lowering drug prices should be a bipartisan issue. It makes absolutely no sense for US citizens to pay excessively high drug prices to support drug research that benefits the entire world – including developed countries with much lower drug prices than the US
President Donald Trump has “rock” back and forth on the issue and advocated for drug price negotiations in 2016 and 2018. He claims Such negotiations would save consumers $300 billion annually.
Toward the end of his first term, Trump signed four drug executive orders. At the time, I 100% agreed with Trump’s stated intention to take on Big Pharma. However, I was extremely skeptical about his sincerity. Was he just making a proposal to attract swing votes before the 2020 election?
Under pressure from massive pharmaceutical companies, Trump has repeatedly backed down without succeeding in lowering prices in either election period. Former Vice President Kamala Harris is right brought this fact to highlight in their 2024 campaign.
The most crucial Trump executive order was one that theoretically reduced the price of drugs under Medicare Part B to the lowest price available to other countries. In the industry this is known as the “most favored nation” price.
For 17 years, I was an executive in purchasing organizations for for-profit healthcare corporations and tried to lower drug prices for some of our nation’s largest nonprofit hospital chains. Compared to what they could achieve on their own, we managed to reduce prices by an average of 20%.
However, our negotiated prices were still much higher than other countries. I know it firsthand. I conducted extensive pricing studies in three western Canadian provinces and was shocked at what I found. Even though their total drug purchasing volume was only a petite fraction of our volume, these relatively petite companies still had much better prices than my employer, the second largest GPO in the country, which purchased billions of dollars’ worth of prescription drugs.
Trump’s three other orders aimed to allow government importation of cheaper drugs from Canada and elsewhere; requiring government-funded health clinics to pass discounts on insulin and EpiPens directly to consumers; and eliminating drug discounts received by pharmacy benefit managers but not passed on to consumers.
The executive order on Canada was at least partially successful. Visit sites like https://www.canadapharmacy.com/prescription can save US citizens significant amounts of money on overpriced drugs like Eliquis and GPL1 weight loss drugs.
I give Trump credit for issuing executive orders on these issues despite the divisions within Trump’s own party. Members of the Republican Congress said his orders were anti-free market, without acknowledging that there is no “free market” for prescription drugs. The market is government controlled in all developed countries, including the United States, through the U.S. Food and Drug Administration.
Frankly, Congress should have acted but didn’t because drug companies’ money goes to members of Congress of both parties, thereby bailing them out. Both parties rely on the significant campaign contributions of these lobbyists. From 1990 to 2024, Big Pharma PACs donated $10 million to the top four Democrats, including President Joe Biden and Harris. She gave 4.5 million dollars to four leading Republicans, including Senators Mitch McConnell and Mitt Romney.
During Trump’s first term, the Democratic-led House of Representatives passed a bill that would have allowed Medicare to negotiate prices for all drugs, but it failed in the Republican-controlled Senate. At that time, my then-congressman and a major pharmaceutical group (Stop Medicare Takeover) sent out a mailer calling the House plan “radical,” “socialism,” “drug rationing,” and “price fixing,” and saying it would result in “withholding medications from the sickest patients.” None of these claims have any basis in fact and were not explained in the mailer.
To lower drug prices, we need a truly committed President and a Congress (Democrats and Republicans like Justice and Capito) that won’t be swayed by Big Pharma’s campaign contributions. If strict bipartisan “most favored nation” drug pricing laws were passed in the House and Senate, it would “truly make America whole again,” said Sens. Justice and Capito. However, this will only happen if public pressure is increased. Lobbyists are currently winning the battle over drug prices.
