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Nancy Pelosi’s Prescription Drug Bill Draws Qualified Praise From Progressives

House Speaker Nancy Pelosi’s proposed bill to lower prescription drug prices has won qualified praise from some of the progressives who have been most critical of her handling of the issue.

“This is an ambitious plan, as any meaningful response to outrageous prescription drug prices and nationwide treatment rationing must be,” Peter Maybarduk, director of Public Citizen’s Global Access to Medicines Program, said in a statement. “Nevertheless, there are important limits on this plan’s capacity to make medicine affordable.”

The California Democrat’s plan would force pharmaceutical companies to negotiate lower prices on as many as 250 of the costliest prescription drugs on the market, according to a summary of the legislation, H.R. 3, published by Bloomberg Government on Monday evening. 

Critically for advocates of affordable prescription drugs, the bill would cap drug prices at an average of the lower rates offered in other nations and levy a 75% tax on gross sales in the previous year for drug makers that do not reach an agreement on lower prices with the federal government. Pharmaceutical companies would also have to retroactively rebate to the federal government the money it made from price increases on drugs purchased by Medicare that have exceeded inflation since 2016.

Previous iterations of Pelosi’s plan, of which her top health policy adviser Wendell Primus has been the architect, covered as few as 25 drugs and relied on an arbitration process between the federal government and drug makers to serve as a backstop in the event of an impasse in negotiation. The prospect of relying on arbitration was a particular sore point with progressives, who noted that it is a process that favors corporations with expensive legal teams.

The most ambitious drug price bill in Congress, introduced by Rep. Ro Khanna, a California Democrat, and Sen. Bernie Sanders, a Vermont independent, goes significantly further than Pelosi’s legislation, threatening to impose generic drug competition on pharmaceutical companies if prices of any drugs ― not just a select group ― exceed the average rates in five developed nations. 

Khanna, a vice chair of the Congressional Progressive Caucus, lauded the plan in a statement for taking on “outrageously high drug prices through direct negotiation as opposed to private arbitration,” as well as the provision tying costs to prices in other countries as his bill does. 

But he expressed hope that Pelosi would consider expanding the universe of prescription drugs over which the federal government would negotiate. “We should not bind our hands when it comes to lowering health care costs,” he said.

Alex Lawson, the executive director of Social Security Works, a nonprofit pushing a tougher approach with drugmakers, echoed Khanna’s call for the bill to include all prescription drugs. He also called for the rebates on price hikes that exceeded inflation to apply to all drugs, not just those purchased by Medicare.

For his part, Maybarduk of Public Citizen took issue with tying U.S. drug prices to rates abroad, arguing instead for “a fresh opportunity to establish fair prices” based on “real research opportunities and investments.”

But overall, the activist response was an about-face from months of griping about a process that they complained they had been shut out of.

“This draft is a good starting point to stop pharma’s outrageous rip-offs,” Lawson said.

This story is developing. Please check back for updates.

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