Misleading: Trump took on Big Pharma and signed orders that will massively lower the cost of prescription drugs.

By: Devika Kandelwal
September 9 2020

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Trump signed four executive orders aimed at lowering the price, but the orders haven't taken effect yet and the text of one is not publicly available.During Trump's acceptance speech at the Republican National Convention, he claimed that he has taken on big pharmaceutical companies and has substantially brought down the cost of prescription drugs. Trump signed four executive orders on July 24, aimed at lowering prescription drug prices. But those orders haven't taken effect yet, and the text of one hasn't even been made publicly available. NPR noted that health policy experts say the orders will likely offer patients only minimal relief and may take months to implement if they're implemented at all. One of the executive orders involves passing on discounts negotiated by insurance middlemen called pharmacy benefit managers at the pharmacy counter — to Medicare patients. (These discounts typically go toward lowering premiums overall, instead.) However, this order includes a section that says that before it can take effect, the secretary of health and human services needs to confirm that the order won't cause federal spending, premiums, or patients' total out-of-pocket costs to increase. Since one of these is bound to result from the executive order, it likely will never go into effect. Experts pointed out that those discounts usually go toward lowering insurance premiums for seniors. Without applying the discount there, premiums would likely go up. And, to keep premiums down, the federal government would need to spend more on subsidies. CNN notes that one executive order allows drug importation from Canada, where prices are much lower. It would also allow manufacturers to import lower-cost versions of the drugs they sell in other countries. However, concerns include whether the medications would be safe and whether Canada has enough supply to make a dent in US prices. Another order directs Federally Qualified Health Centers, which provide primary care services to underserved communities, to pass along discounts on insulin and EpiPens to their patients. The fourth executive order is about tying drug prices to those in other countries. The favored nation executive order has not yet been made public, making it hard to know how the initiative would work. It reportedly would apply only to drugs covered by Medicare Part B ― those that patients receive at their doctors' offices― but not those purchased at the pharmacy counter. Drug companies criticized the executive order. The Trump administration offered to consider an alternative plan if the firms offered it by Aug. 24. So far, the industry has not made a counteroffer. CNN reported that the drug industry would likely take the administration to court if the President moves forward with the orders. We conclude that it's misleading to say that the Trump administration has lowered the prices of drugs. The executive orders have not yet been implemented, and the implications of the orders are currently unknown.