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Opinion: Trump's drug pricing plan promises to hurt Americans

Kenneth E. Thorpe

His days in the White House may be numbered, but that didn't deter President Donald Trump from handing down his most sweeping health care reform to date.

The president recently announced the final rule for his "Most Favored Nation" executive order, which requires Medicare to pay drug makers no more for certain medications than nations with wealth comparable to ours pay.

At first glance, the plan has obvious appeal. It isn't fair that foreign governments pay less for drugs than Medicare — especially since so many of those medicines were invented right here in America.

President Donald Trump handed down his most sweeping healthcare reform to date, Thorpe writes.

But as with all public policy decisions, there's no such thing as a free lunch. The plan will severely reduce access to lifesaving medicines today — and starve America's scientists of the funds needed to invest in tomorrow's new medicines. For all Americans, but especially the almost 150 million folks living with chronic illness, that's absolutely devastating news.

The MFN policy affects drugs covered under Medicare "Part B," which pays for complex medications administered by physicians, like chemotherapy by infusion. But make no mistake, regulators are also eyeing applying the same rule to Medicare Part D, which covers prescriptions from the drug store.

This order immediately threatens the health of some of America's most vulnerable. In fact, in its final assessment of the rule, President Trump's own Centers for Medicare & Medicaid Services admitted as much. CMS concluded that estimated cost savings from the policy were "attributable to beneficiaries not accessing their drugs through the Medicare benefit, along with the associated lost utilization."

In layman's terms, this is an admission that Medicare will save money because patients will stop getting the cutting-edge drugs they need.

For a sense of what this will look like, look at global access to cancer medicines. Over the past decade in the United Kingdom, patients could only access 7 in 10 new cancer medicines. Canadian patients had access to just 59% of them. In the United States, we had access to 96% of all new oncology drugs. 

Given this unbridled access to top-notch treatments, it's no surprise that the five-year cancer survival rate is 42% higher for American men and 15% higher for American women than for European patients.

Or consider the medicines that treat chronic conditions affecting the central nervous system. Between 2011 and 2018, life sciences companies developed 27 new treatments to combat such diseases. Americans could access nearly all — 89% — of these life-changing drugs. German and British patients, on the other hand, could access just 48% and 56%, respectively. And Canadians could choose from a paltry 33%.

If Trump's plan takes effect, American patients will find themselves in the same boat as patients abroad. At best, this means older, less effective medicines that carry greater risks. At worst, it means premature death.

Trump's heartless plan also jeopardizes future medical discovery.

American labs are researching more than half of the 8,000 medicines currently under development worldwide. Three-fourths of these candidates are potential first-in-class treatments for conditions ranging from Alzheimer's and cancer to diabetes and ALS.

By tying Medicare payments to the prices paid overseas, the plan would dissuade investors from funding scientific research. Indeed, according to one recent survey of major U.S. drug companies, 77% indicated that international reference pricing policies would limit their ability to invest in future research and development.

In this July 10, 2018, file photo bottles of medicine ride on a belt at a mail-in pharmacy warehouse in Florence, N.J. Drug companies are still raising prices for brand-name prescription medicines, just not as often or by as much as they used to, according to an Associated Press analysis.

By 2030, an estimated 83 million Americans will have three or more chronic health conditions. Medical advances over the next decade could alleviate their suffering and save their lives. Widespread access to better drugs and medical devices could prevent 16 million deaths and save our health care system an estimated $6 trillion by 2030.

But thanks to President Trump's parting gift on Medicare, such progress may now be little more than a pipedream.

Kenneth E. Thorpe is a professor of health policy at Emory University and chairman of the Partnership to Fight Chronic Disease.