Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Trump Unveils American Patients First Plan

President Trump delivered a highly anticipated address on his administration’s plan to lower drug prices, increase competition, and reduce the amount that people pay in out-of-pocket costs for medication on Friday. American Patients First is a mix of policies already laid out in the White House budget proposal for fiscal year (FY) 2019 alongside some new ideas. It is designed to address four major aspects related to the cost of prescription drugs: high list prices, a lack of negotiating tools in government programs, rising out-of-pocket costs for consumers, and foreign governments freeriding off of American innovation. The blueprint includes both immediate actions and long-term strategies aimed at increasing competition, improving negotiation, incentivizing lower list prices, and reducing out-of-pocket costs. Secretary of the U.S. Department of Health and Human Services (HHS) Alex Azar stated that he believes the vast majority of the plan can be accomplished through administrative action rather than legislative change.

The plan proposes a number of changes to reshape the Medicare program, including offering free generic drugs to seniors, requiring Part D plans to pass on a portion of rebates to the consumer, and capping certain out-of-pocket costs for Part D beneficiaries. The blueprint would reform how drugs in Medicare Part B are paid for and potentially shift more treatments into Part D, where there is more competition. The Administration is considering fiduciary status for pharmacy benefit managers (PBMs) as well as reforms to the 340B drug discount program. The plan proposes to crack down on manufacturer gaming of regulatory processes and eliminate the use of gag clauses by insurers. The Food and Drug Administration (FDA) will also look into requiring the disclosure of prices in direct to consumer (DTC) advertising. Additionally, the President stated his intent to push other developed countries to loosen their price restrictions and pay more for pharmaceutical treatments.

The blueprint was well received by congressional Republicans. Chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee Lamar Alexander (R-Tenn.) issued a statement calling on the Senate to “consider the President’s plan carefully and promptly.” Republican leadership of the Energy and Commerce Committee issued a similar statement.

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