This morning, the Senate Health, Education, Labor and Pensions (HELP) Committee held the first congressional hearing on President Donald Trump’s plan to combat high drug prices, “American Patients First.” The hearing featured testimony from Department of Health and Human Services (HHS) Secretary Alex Azar as well as questions from Committee members. Senators on both sides of the aisle asked questions about the drug pricing blueprint and looked for further insight from the Secretary on next steps the administration would take as well as areas for possible Congressional action.
Rebates were a topic of interest for multiple Senators at today’s hearing. When asked whether rebates in the Medicare Part D program should be removed, Azar said that the idea should be discussed and that his agency would have some regulatory authority in the area since rebates were carved out as an exception in anti-kickback rules. The Secretary did note that he would welcome Congressional action in this space as a way to firm up HHS’ authority to regulate rebates.
Many Senators from both parties used their allotted time to ask about efforts to advance overall transparency and indicate their support for increased transparency in not only drug pricing, but in many areas of health care. This extended to questions about getting consumers information about prices in direct-to-consumer advertisements, an idea that is included in the blueprint and legislation introduced in the Senate. In addition, another suggestion was to provide information about cost when a doctor is prescribing a drug so that a beneficiary knows what their out-of-pocket costs would be and could then potentially discuss options with their doctor.
Other question topics included price negotiation, indication-based pricing, and pharmacy gag clauses. Multiple Democrats expressed disappointment that the administration did not go further to allow the government to negotiate especially based on President Trump’s comments as a candidate that he wanted negotiation. In response, Secretary Azar said that the President is fulfilling his promise by proposing to introduce negotiation into Part B, which would apply for some drugs covered under this part of Medicare.
Throughout the hearing, Secretary Azar emphasized incentives to increase list prices. This is a common talking point related to the blueprint and is mentioned in the administration’s blueprint as one of four key strategies. Rebates and the structure of Medicare Part B were both mentioned as playing into these incentives. Additionally, the Secretary highlighted actions the administration is taking now, such as publicizing complaints related to REMS, but did note that it will take time to accomplish “comprehensive reform.”