Washington Examiner: Outside Groups Prepare to Fight Trump Drug Pricing Proposal

This post originally appeared in the Washington Examiner on January 31, 2019. .

Outside groups prepare to fight Trump drug pricing proposal. Outside groups involved with fighting HIV, epilepsy, and serious mental illness are prepared to battle the Trump administration on a plan to change Medicare Part D, the portion of the program that covers prescription drugs. The administration has proposed making changes to what are known as the “six protected classes” of drugs, which allow certain patients with serious health conditions to receive any drug that their doctor determines is best to treat them. ​

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Under the administration’s plan, aimed at reducing drug spending, insurance companies would be able to require that doctors try certain less expensive drugs first, or require doctors to check with an insurance company before they issue a prescription. The organizations, which receive some funding from drug companies, said such a move would harm patients, even risking their lives, because insurance companies could even discontinue a medication that patients are already finding effective. The organizations, which have banded together to form the Partnership for Part D Access, are lobbying members of Congress to have them undo the proposal if it should become a final rule. If that doesn’t work, they signalled in a meeting with reporters Wednesday that they were prepared to sue.

​“Patients and their families should not be paws in this fight,” said Andrew Sperling, director of legislative and policy advocacy at the National Alliance on Mental Illness. “We are going to continue to push back on the Trump administration on this.” Medicare patients who require the medicines are not only 65 and older, but many of them are younger and qualify for Medicare because their health condition meets the program’s provisions for people with disabilities. The Trump administration finished collecting comments on the proposal Jan. 25.