Trump Signs 4 Executive Orders in Effort to Carry Out Promise to Lower Drug Prices

This story has been updated with links to the orders and reaction.

President Trump, beset with falling poll numbers amidst the continuing coronavirus 2019 (COVID-19) pandemic, signed 4 executive orders Friday aimed at lowering drug prices.

According to the Associated Press, the orders, coming 2 years after the administration first released a blueprint for lowering drug prices, include:

• Allowing states, wholesalers and pharmacies to import FDA-approved drugs from foreign countries
• Using the lowest price similar nations pay for some types of Medicare Part B drugs, including many oncology medications administered in a physician setting
• Directing federally funded community health centers to pass 340B discounts they now receive for insulin and as well as epinephrine auto-injectors directly to low-income patients
• Passing drugmaker rebates, which go to pharmacy benefit managers and insurers, directly to patients

On a call with the media late Friday, HHS Secretary Alex Azar said biologic and injectable drugs would not be an allowed import, but said individuals would be able to re-import their own insulin from Canada. Under another part of the plan, the FDA would allow individuals to import drugs from countries with similar regulatory procedures.

The move was met with derision by Democrats, who last year passed a bill in the House of Representatives to allow Medicare to negotiate drug prices directly and cap out-of-pocket drug costs. In addition, a bipartisan Senate bill supported by Trump stopped short of giving Medicare bargaining power, but would have limited annual price increases and also capped costs. Although the bill passed out of the Senate Finance Committee, Senate Majority Leader Mitch McConnell, R-Kentucky, never brought the bill up for a vote, as Trump did not actively push for it and Senate Minority Leader Charles E. Schumer, D-New York, preferring the House bill.

"Americans need lower drug prices now, not some day in the future that may never come. The president has had over a year to bring Congress together on a bipartisan plan to lower drug prices, but he has chosen to take the easy route of empty rhetoric instead," said Senate Finance Committee Ranking Member Ron Wyden, D-Oregon, in a statement.

CMS Administrator Seema Verma said the administration is giving the pharmaceutical industry 30 days to come up with their own alternative to international pricing for Part B drugs.

In the meantime, Azar said the administration would move forward with "operational planning" to put the orders into effect.

"Debate is over," he said.

The trade group representing the biotech industry released a letter it said it sent to the president asking him to stop any attempt to link Medicare drug prices to the lower prices the elderly pay in other developed nations. BIO called the plan "patient-harming and innovation-killing price controls."

The Community Oncology Alliance said it supported some aspects of the announcement, such as the section on passing rebates on to Medicare beneficiaries.

America’s Health Insurance Plans (AHIP), meanwhile, said the rebate rule will increase costs. “The problem is the price. With the greatest urgency, the Administration should focus on bipartisan, workable solutions to protect patients, taxpayers, and all Americans from higher drug costs in their greatest time of need, especially in the middle of the COVID-19 crisis,” said Matt Eyles, AHIP's president and CEO.