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Nocturnal Reflections on Trump’s Blurry Overtures on Drug Prices

Night owl drug prices

Forcing price transparency in drug ads, proposing international reference pricing for Medicare Part B, and even drug importation can all be found in President Trump’s lunchbox of policy ideas to take on the drug companies, who are “getting away with murder.”

Huh, am I dreaming?

Is Donald Trump really a Republican? Is former Eli Lilly President Alex Azar, now HHS Secretary, really advocating such radical ideas, such as importation, against his pharma friends? Scott Gottlieb, our free-market fanatic FDA Commissioner is crusading against high drug prices, too: winner of Patients for Affordable Drugs Price Fighting Hero Award!

Pinch me. Am I awake?

I am awake and I’m not fooled by this subtle, probably well planned out public relations defense against the progressive and populist tide, which includes Republicans and Democrats. Forget importation this week: 92% of Republican and 96% of Democratic voters support ending the ban on Medicare negotiating drug prices. Finally, the country is united!

Ending the ban on Medicare price negotiations could bring down prices for drugs in all of Medicare.

But Alex Azar’s proposal to reduce drug prices in Medicare is only for Part B, half the country, and on a small group of medications. Forcing drug companies to list prices on TV drugs ads does not bring those prices down. And the importation idea is good, but super limited, and it’s still just talk!

Jamie Love from Knowledge Ecology International’s comment on Trump’s Medicare Part B proposal is caustic yet correct in describing the Trump administration’s policy and general approach:

“If one was to design a program that appeared to address the need to curb high prices for drugs, without doing much in Trump’s first term, and promising nothing after 2025, it might look like the proposal.”

On the other hand—and this is where compromise begins to seep in and you can’t help but know it’s because Trump is no normal Republican—the former President of Eli Lilly USA, Alex Azar, is advocating for forcing price reductions on drugs in Medicare Part B and importing foreign versions of lower-cost medications for single source drugs; and working in an administration giving voice to drug price transparency. Who would have thought that possible two years ago?

Not me. Am I dreaming?

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AEI Scholar Calls for the Decriminalization of Personal Drug Importation; Suggests Consumers Check List of Approved Online Pharmacies

As too many Americans skip taking their medication due to cost, the issue of drug affordability is of critical importance to public health. It is also one that politicians ignore or wrongly address to their peril. Urging Republican lawmakers not to ignore Americans who are struggling with high drug prices, Roger Bate of the American Enterprise Institute recommended a nuanced, free-market approach to the problem of high drug prices. In an article published yesterday by AEI, Mr. Bate called for the decriminalization of personal drug importation and the continued statutory ban on wholesale drug importation. By doing so, more Americans who are disadvantaged by high drug prices can find relief through safe and affordable international online pharmacies, while not undermining pharmaceutical research and development in the United States, which, he argues, relies on the maintenance of our wholesale drug importation laws.

Underscoring Mr. Bate’s position was his recognition, based on his own empirical research, that Americans who purchase brand name prescription drugs from non-U.S. pharmacies could do so with confidence by consulting the approved list of online pharmacies found on

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