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We have been monitoring the discussion of the price of prescription drugs. It is no secret that a pillar of Donald Trump’s presidency and the newest members of the 116th Congress is the promise of lowering prescription drug prices for millions of Americans who pay far too much. Recently, HHS Secretary Alex Azar has indicated the administration might roll back the current prescription drug rebate program. However, there has not been a promise from drug companies to lower drug prices if rebates are taken away, nor has there been a promise to help patients afford their prescription medications. (Linda Goler Blount, 12/11)

Gilead Sciences Inc. has been in leadership limbo for five uncomfortable months; replacing a CEO and chairman combination that turned the company into a giant isn’t easy. So the hiring on Monday of Roche Holding AG pharma head Daniel O’Day comes as a significant relief. It ends uncertainty, for sure. More important, O’Day is clearly qualified. He’s a veteran of one of the world’s most successful pharma firms and has deep expertise with cancer medicines, a priority for Gilead.  (Max Nisen, 12/10)

A rare point of consensus following the midterm elections is that Americans are adamant about lowering drug prices. Bipartisan pledges to seek common ground on this vexing issue suggest we might finally see action to make medicines more affordable. What should this new common ground look like? Beyond important proposals like allowing drug importation or Medicare negotiation, policymakers should take a hard look at one of the key factors affecting market competition, transparency, and affordability: patents. (Tahir Amin, 12/7)

The Trump administration has proposed several steps to address the cost of prescription drugs. Reaction mostly ranged from unimpressed to strong opposition. Rather than relying on bureaucratic micromanaging and price controls, we need to explore market solutions that expand access and encourage pharmaceutical innovation — and some are already here.The good news is that the large majority of prescription drugs are very affordable. Generics, which are much less expensive copies of original brand-name drugs, represent nearly 90 percent of prescriptions sold in the U.S. (Merrill Matthews, 12/9)

With pressure mounting from the outside, the industry was left with no choice but to look within to reduce costs. Although the pricing scheme of pharmacy drugs and services is a closely guarded secret, we’ve learned that the complexity of the industry is what’s likely driving up costs. Insurance companies, pharmacy benefit managers, retail pharmacies, manufacturers, and wholesalers are all involved in the process to provide Americans with services and prescription drugs. For example, a brand-name drug is made by a manufacturer, then purchased and distributed by a wholesaler, who sells it to the pharmacy. Meanwhile, pharmacy benefit managers reimburse the pharmacy for the drug, and insurance companies reimburse the pharmacy benefit managers. With so many players involved in a single drug, it is clear to see the multiple points of pricing negotiations that take place. (Kathleen Iacocca, 12/12)