Dear Colleague,
Teddy Roosevelt said, "Speak softly and carry a big stick." President Trump doesn't speak softly, but he's got the "big stick" part down pretty good.
He's been threatening tariffs on pharmaceuticals since January, and last week he announced that brand drug makers would pay a 100 percent import tax if they don't have U.S. production facilities. This week, he held a press conference with the head of Pfizer, who announced that the company would be lowering prices on some of its products to match what other countries pay. He also pledged new facilities in America. Similar deals with other companies are in the works. All because of the big stick.
We support the president's focus on bringing drug prices down and bringing drug manufacturing back. As I said in a statement on Tuesday, Americans pay the highest drug prices in the world because it is the only country in the world where PBMs run the prescription drug benefit. Allowing foreign countries to supply our most important medicines is a risk to our national security and our supply chain.
However, we have a lot of questions about another initiative: TrumpRx. It's billed as a website that will allow patients to buy certain drugs directly from manufacturers at discounted prices. There were very few details, but it appears to follow the "pharm to table" model created by some manufacturers. This is not a solution. In fact, it's dangerous. Websites can't counsel patients, recognize other potential health risks, or follow up to make sure patients are taking their medicines at the right time and in the right amount. The president has been very clear about his disdain for voting ballots sent through the mail. Prescription medications are just as important.
There are alternative methods for creating a direct-to-patient program that would tap into the huge network of almost 19,000 independent pharmacies. The President can realize his vision without compromising the patient-pharmacist relationship, and without sending patients on a scavenger hunt all over the internet for the drugs they need.
The insurance companies and their PBMs get paid more when patients and taxpayers pay more. That's the problem. The president knows this, which is why he promised multiple times to "cut out the middlemen." The only real solution is PBM reform. This isn't the way to do it.
Neither is letting the PBMs police themselves. Last week, Bloomberg reported that the PBMs are pitching a scheme that would let them reform their own practices. Did you get that? The worst actors in health care for decades are suddenly ready to turn over a new leaf.
Our statement laid out the case: "They've been fined hundreds of millions of dollars by multiple states for ripping off public benefits programs. Their anti-competitive behavior is well documented by Congress, the FTC, and multiple national news investigations. Their self-dealing and cut-throat practices have triggered legislation in nearly every state. This would be like letting Al Capone police himself." Leopards don't change their spots.
To the president's credit, the PBMs wouldn't be promising to go straight without his tough talk and the threat of a big stick. His head of the FTC, Andrew Ferguson, who visited one of our members, has also been critical of the PBMs. So have all the officials we've met with in the departments of Justice and Health and Human Services. And there is bipartisan support in Congress for PBM reform. The PBMs aren't having a religious conversion. They are scrambling. Congress should pass PBM reform now and we would look forward to working with the administration to continue to provide prescriptions to patients safely, efficiently, and, without the PBM markups, at the lowest possible cost.
Best,
B. Douglas Hoey, Pharmacist, MBA
NCPA CEO
P.S. The teddy bear was named after President Roosevelt during a hunting trip in Louisiana where New Orleans will be hosting NCPA's Annual Convention two weeks from now.
