Top Republicans on three committees in the U.S. House of Representatives on Monday pitched a new drug-pricing package as an alternative to House Speaker Nancy Pelosi's (D-Calif.) government drug price negotiation plan, which is likely dead on arrival in the Senate.
Though the House Republicans' hodgepodge of bipartisan drug-pricing provisions almost certainly will not get a floor vote in the House, Energy & Commerce Committee Ranking Member Greg Walden (R-Ore.) said the leaders are planning to ask the Rules Committee to allow their bill to get a vote on the House floor as an amendment to Pelosi's bill.
"We think it is a substantive, full-throated alternative that can pass and become law," Walden said.
The drug-pricing legislation is substantially similar to a bill Walden put forward at the Energy & Commerce markup on Pelosi's bill, but Walden said he, Ways & Means Ranking Member Kevin Brady (R-Texas) and Education & Labor Ranking Member Virginia Foxx (R-N.C.) had held out hope that Democrats would eventually want to pursue bipartisan legislation on drug pricing. Pelosi's plan has not garnered Republican support.
Walden has claimed that House committee leaders were close to a bipartisan agreement on a drug-pricing package before Pelosi's bill was introduced. Leaders of the Ways & Means and Energy & Commerce committees released a discussion draft of a Medicare Part D redesign that would have capped out-of-pocket costs for seniors over the summer, but the inquiry did not lead to bipartisan legislation.
Brady said he hoped Democrats would still come around after Pelosi's plan fails to gain traction in the Senate.
"They are rushing it to the floor this week, and it is deader than a doornail. We're hopeful when that's done, we can join together back on the path of consensus," Brady said.
The legislation incorporated some elements similar to the Senate Finance Committee's drug-pricing package, but did not include a controversial provision that would force drugmakers to pay back Medicare for price hikes above inflation.
"I'm not a fan of incorporating that sort of arbitrary caps," Walden said.
Senate Finance Chair Chuck Grassley (R-Iowa), who authored the Finance Committee drug-pricing package with Ranking Democrat Ron Wyden of Oregon, backed the House Republicans' effort, though he has refused to strip inflationary rebates from the finance legislation.
House GOP lawmakers, like the Senate Finance Committee, proposed creating an out-of-pocket cap for patient costs in Medicare Part D of $3,100. However, the breakdown of costs in the benefit is a bit different. Drugmakers would pay 10% in the initial phase and catastrophic coverage phase in the House version, while the Senate's new bill would have drugmakers pay 7% of costs in the initial phase and 14% in the catastrophic phase.
The House legislation also includes a provision that would codify a Trump administration rule to require drugmakers to disclose list prices in television advertisements. The bill was not included in Senate packages on lowering healthcare costs, and the rule was blocked by a federal judge.
The House GOP package would create a position with the Office of the U.S. Trade Representative titled the "chief pharmaceutical negotiator" to represent American drugmakers' interests abroad. The provision also appeared in legislation introduced by Rep. Mark Meadows (R-N.C.) in July. Meadows has said he shares President Donald Trump's concern about foreign freeloading off of the United States' high drug prices, but he does not like the administration's international reference pricing demonstration.
Other policies in the bill would cap add-on payments for some physician-administered drugs, limit patent gaming, increase transparency throughout the prescription drug supply chain, create a monthly cap for insulin costs, ensure branded-drug makers do not withhold drug samples needed for generic development, and change the conditions of first-generic exclusivity.
