The Senate Finance Committee is still negotiating major pieces of legislation to lower drug costs, and leaders are staying mum on what's holding up the bill as they seek to cut prices within Medicare Part B and Part D.
"There are a couple of very tough issues you have to work out," Senate Finance Committee Chair Chuck Grassley (R-Iowa) said Wednesday. "But there's one sure thing: I want cheaper drug prices and we're going to do everything we can to work towards cheaper drug prices."
The panel's Ranking Democrat Ron Wyden of Oregon said he and Grassley are meeting daily and sometimes several times a day about the proposals, which are now expected to come after the July Fourth recess, but he also declined to discuss specifics.
"The bottom line here is you've got to have meaningful steps to rein in high drug prices," Wyden said, adding that the "focus is on getting it right."
Grassley also came out against the Trump administration's international reference pricing model for Medicare Part B. He said he would only be interested in third-party negotiation within Medicare Part B for specialty drugs.
The Senate Finance Committee's legislation is aimed at cutting prices in Medicare Part B and Part D and Medicaid, as Congress wrestles with how to deliver on a signature healthcare promise by both parties and the White House. The panel is also looking to restructure Medicare Part D's catastrophic coverage phase, which U.S. House of Representatives leaders are planning as well, to put a stop to incentives that drive patients into the catastrophic phase faster.
Focus on the Finance Committee's work is renewing now that the Senate health committee has finished its legislation on healthcare costs, with a panel vote scheduled for next week.
The House also hasn't released its proposal for Medicare Part D prices yet, and a representative for House Speaker Nancy Pelosi (D-Calif.) didn't have an update as to timing.
On Wednesday night, Pelosi told lawmakers that the list of drugs to be negotiated could exceed 250, according to Rep. Mark Pocan (D-Wis.), who co-chairs the Congressional Progressive Caucus and wants a "bold" proposal to lower prices. Pelosi also said she would start tasking the committees to work on the drug pricing proposal, accordingot Pocan, although he doubts a policy will be ready before the August recess.
This plan has shifted from the establishment of private-sector binding arbitration to authorizing the HHS secretary to negotiate with the manufacturers of about 250 particularly expensive drugs, using a tax penalty as leverage.
In addition to drug list prices, the Senate Finance Committee is looking at long-term financing of expensive gene therapies, which Grassley framed as an equity issue for people in poverty to have access to the same options as people with private insurance and high incomes.
"So many of these things end up saving money in the long term, but states can't afford it all in one year or one payment," he said. "So let's spread it out, otherwise how are you going to guarantee equity for people who are on Medicaid compared to other people that have access?"