April 10, 2019

The Trump Administration's Efforts to Reduce Drug Spending: How Will They Change the Landscape?

The market for pharmaceutical products has structural flaws that have led to reduced competition, increased prices and high out-of-pocket costs for consumers. Over the past 12 months, the Trump administration has floated a range of proposals with the stated intent of reducing prescription drug prices and spending while the FDA has enacted expedited reviews for generic drugs and is promoting more rapid approval and adoption of biosimilars. In November, the administration released proposed rules intended to reduce costs in Medicare Part D by modifying protected class requirements, improving price transparency at the time prescriptions are ordered, and requiring pharmacy price concessions for consumers at the point of sale. In January, a proposed rule was released that would eliminate drug rebates in Medicare and Medicaid. It also released an advanced notice of proposed rulemaking (ANPRM) under which Medicare would determine payments for some Part B drugs based on prices paid by other countries for the drugs. If enacted as written, these proposals would disrupt the market for pharmaceutical products. Yet the ultimate impact of these proposals is unknown and will depend on the behavioral responses of drug firms, PBMs, payers and consumers. This Forum will focus on further defining the potential impacts of proposals in three major areas: the elimination of pharmaceutical rebates; the adoption of international reference pricing or other strategies that would limit the price of Part B drugs; and the future growth of the biosimilars market and its impact on competition and drug prices. 

Speakers include:

  • Stuart Altman, PhD, Professor, Brandeis University
  • John O’Brien, Senior Advisor to the Secretary for Drug Pricing Reform
  • Mark Miller, PhD, Executive VP of Healthcare, Arnold Ventures
  • Kevin Schulman, MD, Professor, Stanford University
  • Matt Eyles, President and CEO, AHIP
  • Lida Etemad, PharmD, VP Pharmacy Management Strategies, UnitedHealthcare
  • Stacie B. Dusetzina, PhD, Associate Professor of Health Policy and Cancer Research, Vanderbilt University School of Medicine
  • Randy Burkholder, Vice President for Policy and Research, PhRMA
  • Rena Conti, PhD, Associate Professor, Boston University
  • Anthony Barrueta, Senior VP of Government Relations, Kaiser Permanente
  • Ameet Sarpatwari, JD, PhD, Assistant Director, Program on Regulation, Therapeutics and Law, Harvard Medical School

Agenda

Presentations

Current Congressional Proposals to Control Drug Spending
Mark Miller, PhD, Executive VP of Healthcare, Arnold Ventures

The PBM Market in the U.S.
Kevin Schulman, MD, Professor, Stanford University

Eliminating Pharmaceutical Rebates: What Is the Likely Impact on Prices and Spending for Consumers, Payers, and Government?
Matt Eyles, President and CEO, AHIP

International Reference Pricing and Other Options For Limiting Spending on Drugs
Stacie Dusetzina, PhD, Associate Professor of Health Policy and Cancer Research, Vanderbilt University School of Medicine

The U.S. Biosimilar Market: Stunted Growth and Possible Reforms
Ameet Sarpatwari, JD, PhD, Assistant Director, Program on Regulation, Therapeutics and Law, Harvard Medical School