A House committee on Thursday approved a Democratic bill designed to limit drug prices, a top priority for the party, as another panel’s debate on the measure was poised to last for hours.
House leaders produced the 141-page bill after months of deliberations among various party factions, as progressives urged their colleagues to be bold despite GOP criticisms that the measure could hamper research into future cures. The bill, numbered HR 3, includes requirements for the Department of Health and Human Services to negotiate Medicare prices for the most expensive drugs, with commercial health plans also having the option of adopting those prices.
The Education and Labor Committee approved the bill on a party-line vote of 27 to 21 after adopting a substitute amendment that was unveiled Wednesday.
The committee adopted all four Democratic amendments that were offered, while rejecting all eight Republican amendments. Adopted changes include a measure from New Jersey Democrat Donald Norcross would ensure that copays under participating commercial employer plans don’t exceed negotiated prices.
An amendment from Washington Democrat Pramila Jayapal and another by Massachusetts Democrat Lori Trahan would require studies on the effects of extending the inflation cap to employer plans and the effects of price negotiation, respectively.
Meanwhile, as of Thursday afternoon, the House Energy and Commerce Committee had only begun debating a handful of the dozens of amendments that were filed.
The committee adopted a bipartisan amendment from Reps. Kurt Schrader, D-Ore., and Greg Gianforte, R-Mont., that would increase reimbursements for generic versions of complicated, expensive biotech drugs for five years.
Under the part of Medicare that covers doctor visits, Part B, health providers buy the drugs and are reimbursed at a 6 percent markup of the drug’s average sales price. To encourage more widespread adoption of the generic versions of biologic drugs, known as biosimilars, the amendment would provide an 8 percent markup over a biosimilar’s average sales price.
After the death early Thursday of Oversight and Reform Committee Chairman Elijah E. Cummings, D-Md., a prominent voice on drug prices, Speaker Nancy Pelosi of California said the bill would be named in his honor.
When committees met to discuss the bill Thursday in the Energy and Commerce and the Education and Labor markups, and at a Ways and Means hearing, members started with moments of silence and praise for their colleague.
But the meetings quickly regressed into partisan debates.
“Let’s be clear, governments don’t negotiate,” North Carolina Republican Virginia Foxx said at the Education and Labor markup. “They dictate.”
Republicans accused Democrats of handicapping the future of innovative drugs, while Democrats accused Republicans of borrowing arguments from the drug industry’s playbook.
“When I hear my colleagues across the aisle attack HR 3 as not being a bipartisan work product, I just want to ask them, where is your work on prescription drug pricing from the years that you had the majority in the House, the Senate and the White House?” Pennsylvania Democrat Susan Wild said at the Education and Labor markup. “Nonexistent. Stop protecting rich corporate executives and start thinking about your constituents.”
House Republicans frequently reminded committee Democrats that Senate Majority Leader Mitch McConnell, R-Ky., has already said he wouldn’t bring up the bill in the Senate.
The legislation is primarily viewed as a starting point for negotiations with the Senate if leaders decide to seek a compromise. The inclusion of several policies endorsed by the Trump administration suggest Democrats hope the president might back some policies that Republicans typically oppose.
The bill could lead to $345 billion in savings over a decade, the Congressional Budget Office said in a preliminary estimate. That savings would mostly come from setting the U.S. prices at an average of what six foreign countries pay. Around $42 billion would come from reductions in other medical spending, since CBO estimated that lower drug prices might drive people to use a prescription rather than get a more costly medical procedure.
Ways and Means outlook
The Ways and Means Committee plans to mark up the bill next week. At Thursday’s hearing, GOP panel members raised concerns that the partisan nature of the House drug price plan would make it harder to reach a deal with the Senate.
Ways and Means member Tom Reed, R-N.Y., said Thursday he had met with senators that morning who were concerned that the Senate would not discuss legislation other than articles of impeachment during a Senate trial, possibly preventing any drug pricing bills from passing before the end of the year.
“I’m very concerned that if we’re going to pursue HR 3, given the backstop of what we’re facing in the Senate, our window of opportunity here is going to be very short to get something done,” he said. Instead, lawmakers should pursue other measures that would lower drug prices but have bipartisan support, Reed argued.
Republicans have criticized Democrats from retreating from bipartisan talks on drug pricing legislation, including revamping Medicare’s prescription drug benefit, in favor of the proposal backed only by Democrats.
GOP lawmakers argue the bill would lead to less innovation and fewer new treatments.
“It is dangerous, and as the Congressional Budget Office has conceded, will stop life-saving cures from getting to the patients who need them most,” Rep. Kevin Brady, R-Texas., the panel’s ranking member, said in his opening statement. "These are the medicines that could be the answer to some of the most heartbreaking and devastating diseases our children, seniors, and families are facing.”
The CBO said that with estimated revenue losses, the drug industry would likely produce 8 to 15 fewer drugs over the 10-year period than it would have otherwise. While the Food and Drug Administration might be expected to approve 300 new drugs in that period, based on historical averages, the drug industry hopes that the possible loss of 8 to 15 drugs might irritate voters.
Rep. Ron Kind, D-Wis., said he was sympathetic to the need to provide clarity for pharmaceutical companies to make sure they invest in research and development but said the bill had provisions to encourage that.
“We need them on the cutting edge and doing this discovery,” he said.
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