President Donald Trump arrived at the Brady News Briefing Room in the White House on January 30, 2025 in Washington, DC.
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president Donald Trump Milestone processes may not be eliminated Medical insurance negotiates drug prices With the manufacturer, even if he moved away other historic policy achievements of Joe Biden.
But Trump may be about those Price talkthis may not require the help of Congress.
“Trump is looking for the law’s edge,” said Matthew Kupferberg, a partner at Frier Levitt’s Life Sciences Group. The president added: “At present, there is no desire to give up drugs altogether,” he added. Negotiation process.”
However, it is not clear which way Trump tends to be. While some lawmakers and health policy experts say Trump can weaken negotiations in a way that helps the pharmaceutical industry, others say he can redouble his efforts and try to save patients and the federal government more money to surpass his predecessor .
The path he took could offer a huge stake in the price of the 68 million Medicare beneficiaries in the United States to cover their drug costs. This will also have a significant impact on companies like this Novo Nordisk,,,,, Bristol Myers Squibb,,,,, Pfizer and Merckwhich included the first two rounds of talks on drugs.
Negotiation is Key Regulations Biden’s Inflation Reduction Act (IRA) aims to reduce prescription drugs costs for older people and save the government nearly $100 billion in Medicare spending over the next decade. The pharmaceutical industry is strongly opposed to price negotiations, a series of lawsuits that they threaten profits and prevent drug innovation.
The Trump administration has few details about its approach to negotiations, except that it will Aim to “improve transparency” During the second cycle of the process, and any ideas to improve the process from external stakeholders were heard.
Making a major change to the law or repealing it completely would be an uphill battle because it requires the help of Republican-majority Congress. High health care costs gain high bipartisan support in a country where patients pay Two to three times For those in other developed countries, prescription drugs become a possible unpopular move than Trump.
So the Trump administration can take action differently from Biden’s actions, including changing how the administration interprets the law’s criteria for drug selection and other potential changes.
“I think it’s a question of how they interpret certain legal languages,” said Juliette Cubanski, deputy director of policy programs at Medicare at the health policy organization KFF.
Cubansky said we can expect any changes in the coming months.
Trump administration to begin a months-long negotiation process The second cycle of 15 drugsthis will take effect in 2027. The Biden administration chose the drugs in January before Trump took office. Pharmaceuticals must decide whether to attend the talks by the end of February, and they may face severe financial fines otherwise.
What can Trump do by himself
So far, Trump has only expressed the need to increase transparency in Medicare drug price negotiations. Kupferberg said this could mean more information about the government’s choice of drugs or settlement prices.
In the first round of negotiations, Medicare Public input From patients, caregivers and consumer groups. But Coupferberg said the Trump administration could take action to introduce other stakeholders, besides manufacturers and patients, such as insurance companies and even middlemen, called pharmacy benefits managers.
“It could be a broader negotiation process,” he said.
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Amy Campbell, associate dean of law and health sciences at the University of Chicago Law School in Illinois, said the government could also reinterpret the law’s guidelines, which could change the choice of choice products and the price drop.
For example, the IRA said that the drug chosen to negotiate must be on the market for at least seven years without a general competitor or in the case of biological products such as vaccines, which must be sold on the market. But the Trump administration may have “loose standards” when choosing another round of drugs to determine whether drugs compete in the market and should be exempt from negotiating prices, Campbell said.
KFF’s Cubanski said Trump could also modify Medicare to consider a drug for negotiation purposes. Currently, different products with the same active ingredients can be selected as one product, the pharmaceutical industry be opposed to.
For example, the Biden administration includes three branded drugs from Novo Nordisk, with the same active ingredient – Semaglutide – a product in the second cycle of the price conversation. These include weight loss medications, diabetes pills and anti-obesity injections. Of these three, Ozespi constitutes the Lions’ health insurance expenditure.
Both of these changes can change how Medicare’s drugs benefit drugmakers and reduce their revenue they lose from lower prices.
The bigger question, Cubansky said, is how Medicare will negotiate prices under Trump. Currently, the final negotiated price of a drug cannot exceed the upper limit, or “Ceil” Priceestablished by the IRA.
Trump could impact whether the initial price quote for Medicare is closer to the cap price, which could undermine the program’s ability to get deeper discounts.
Bigger changes in Congress are a challenge
There may be much less significant changes in price negotiations because they require the help of Congress. For example, one of the biggest problems in the pharmaceutical industry is what drugmakers call “pill fines.”
The law is essentially a new negotiated price of vaccines and other biological agents after we have obtained our approval 13 years, compared to a small molecule drug that only 9 years ago appears in the form of pills or tablets. The industry argues that the difference discourages companies from investing in the development of small molecular drugs, which is more convenient for patients.
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Cubansky said bipartisan legislation was proposed last year propose Eliminate pill fines. If the bill does it through Congress and Trump’s table, “I don’t understand why he doesn’t sign it,” Cubansky said.
She added that there seems to be an increasing interest in legislative changes to the negotiation plan, but “whether you get enough support in Congress is still an open question.”
Jesse Dresser, a partner in the Department of Life Sciences in Frier Levitt, said the bipartisan support for the IRA changes is not the same as support for the IRA changes.
“I can see what happened much earlier (PBM reform) than I want to open up the IRA and adjust it, even if it’s something the government may end up falling behind,” the dresser said.
The legal struggle is still waiting
It is unclear how Trump will engage in an ongoing legal battle between the manufacturer and the federal government with the Medicare program.
The legal challenge in the pharmaceutical industry believes that negotiations are unconstitutional and should be stopped and so far have not been successful in court. Nine lawsuits It is underway as of January.
“Will the Trump administration continue to defend the plan? Or maybe it’s less active in defending the plan?” Cubansky said. “I think these are some key issues.”
If the Trump administration stops defending the plan in court, judges can make decisions on the matter without any opposition, Kuppferberg said. But he said he did not believe the government would want this result.
Coupferberg said the Trump administration could “control the process, the parties reach an agreement to modify and change the interpretation of the law.”
He added that it seems that Trump does not seem to want the entire negotiation plan to disappear under the lawsuit. Coupferberg said it was because it was to replace the replacement for Medicare drug negotiations, which would put Trump in that state, and we “had not seen him yet.”
