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A key Senate committee on Thursday advanced a sweeping bill to lower drug prices after its members voted — narrowly — to retain its most controversial element: a cap on some drug price increases under Medicare. The broader package passed by a 19-9 margin and earned unanimous support from Democrats. GOP lawmakers opposed the legislation by a 9-5 margin. Just before the final vote on the package, a top Republican had attempted to strip the bill of its most contentious element: a cap on drug price increases that exceed the rate of inflation in the Medicare program. (Facher and Florko, 7/25)

The bill would for the first time limit out-of-pocket costs medication costs faced by seniors to $3,100, starting in 2022. Currently there is no cap, and some Medicare recipients face copays rivaling a mortgage payment. It would also require drug companies to pay rebates to Medicare if they raise prices faster than inflation. Those inflation rebates are a problem for some Republican senators, who see them as a pathway to government price controls. (Alonso-Zaldivar, 7/25)

The large number of GOP defections doesn't bode well for the likelihood of Senate Majority Leader Mitch McConnell (R-Ky.) bringing the bill up for a vote in the full Senate, at least not without substantial changes. The bill would impose a limit on drug price increases in Medicare’s prescription drug program, called Part D, by forcing drug companies to pay money back if their prices rise faster than inflation. (Sullivan, 7/25)

The provision would affect how much of a price increase Medicare will pay for existing drugs; it basically demands full rebates for the amount that a company raises the price for a drug above the rate of inflation. It is considered the cornerstone of the proposed legislation negotiated over six months by committee Chair Chuck Grassley (R-Iowa) and ranking member Ron Wyden (D-Ore.). It also accounts for a large portion of the more than $100 billion in savings over a decade projected by the Congressional Budget Office for the government and Medicare beneficiaries. Throughout Thursday's committee markup, Sens. Mike Crapo (R-Idaho), John Thune (R-S.D.) and others blasted the policy as a "price control" or hurting the "free market" aspects of Medicare Part D. These statements echoed points laid out by the Pharmaceutical Research and Manufacturers of America, the leading trade association for pharmaceutical companies. (Luthi, 7/25)

Kaiser Health News: GOP Senators Distance Themselves From Grassley And Trump’s Efforts To Cut Drug Prices

Other obstacles have piled up. Wyden announced that Democrats, who provided most of the bill’s support in committee, would not allow a Senate vote without the Republicans agreeing to hold votes on cementing insurance protections for people with preexisting conditions. Democrats have complained for months that GOP efforts to kill the Affordable Care Act will leave people with these medical problems without any recourse to get affordable health care. Democrats also want to empower federal health officials to negotiate drug prices. Here are the three major problems revealed in Thursday’s hearing. (Huetteman, 7/25)

The Senate’s most senior Republican, facing backlash from drug makers and his own party, is trying out a new pitch for his sweeping drug pricing package: You might not like it, but it’s better than what the Trump administration and House Democrats are likely to come up with. “Who knows what he’s going to do at the last minute,” Senate Finance Chairman Chuck Grassley (R-Iowa) told reporters Thursday, referring to Trump. (Florko, 7/25)

The main pharmaceutical industry lobbying group said on Thursday it and some drugmakers met with President Donald Trump to voice opposition to a bipartisan U.S. Senate bill that aims to lower prescription drug prices. The White House, which has said it backs the legislation, has promised to bring down drug prices for U.S. consumers, an important campaign issue for Trump, a Republican, as well as for Democratic rivals vying to oppose him in the November 2020 presidential election. (7/25)

Trump has railed against high drug prices and has put forward a proposal to tie Medicare drug prices to lower prices in other countries, which PhRMA strongly opposes. Trump has also said he is working on an executive order on drug prices, though details are not clear. The White House downplayed the implications of the meeting with drug company executives, saying Trump is not negotiating with them and that it was McCarthy who asked for the meeting.(Sullivan, 7/25)

“We had a productive meeting with President Trump on how to lower medicine costs for patients,” said Holly Campbell, a spokeswoman for the trade group. She added: “We agree our health care system needs to change and are committed to working with the Administration and Congress to advance policy reforms that will result in immediate and meaningful savings for patients at the pharmacy counter.” The person said the session took place at the request of House Minority Leader Kevin McCarthy, a California Republican. (Sink and Edney, 7/25)

Kaiser Health News: Klobuchar Says D.C. Has Enough Drug Lobbyists To Double-Team Lawmakers

Senior citizens care a lot about drug prices and the future of Medicare, so it was no surprise that at a July 15 AARP-sponsored presidential candidate forum in Iowa the first question posed to Sen. Amy Klobuchar was on those topics. As president, Klobuchar said, she would unleash the bargaining power of Medicare to lower drug prices. But she noted what she would be up against: “There are, literally, two pharmaceutical lobbyists for every member of Congress. They think they own Congress. They don’t own me.” (Appleby, 7/26)

The Trump administration has softened its stance on drug importation, giving a boost to states that want to curb rising drug prices by importing medications from Canada. Health and Human Services (HHS) Secretary Alex Azar last week said he and President Trump “are committed” to making importation work. (Weixel, 7/25)