Raise your hand if you believed Donald Trump’s repeated promises to take on Big Pharma. What about the presidential boast that drug prices for the American people “will come way down?”
Anyone?
Sadly, skepticism about the true impact of Trump’s populist posturing on drug pricing has proven to be well justified. As a worried nation focuses on the looming danger of the Senate vote to repeal the Affordable Care Act, the pharmaceutical industry has joined hands with the president who once said its corporate members are “getting away with murder.”
This week, the New York Times obtained a draft of a planned President Trump executive order on drug pricing. As Patients for Affordable Drugs founder and cancer patient David Mitchell told the Times, the text indicates that “Pharma has captured the process.”
The order, which appears likely to be rolled out after the dust settles on the Affordable Care Act repeal effort, was reportedly written largely by Trump budget staffer Joe Grogan, who was hired by the administration fresh from his role as a drug industry lobbyist. But Grogan is certainly not the only one carrying Big Pharma’s interests into the Trump administration. Secretary of Health and Human Services Tom Price has been a heavy investor in the pharma industry, and FDA Commissioner Scott Gottlieb spent years collecting hundreds of thousands of dollars in consulting fees from pharma companies. Predictably, Trump’s team has written an executive order that reads like a Big Pharma wish list of eased regulation and extended monopolies.
Conspicuously absent from the proposed Trump order are the most logical and popular reform proposals, including allowing the Medicare program to use its massive purchasing power to negotiate lower drug prices. Trump has explicitly endorsed Medicare negotiation in the recent past, and the shackles on Medicare are a key contributor to patients in the US paying the highest medicines prices in the world. But there is no mention of Medicare drug price negotiation in the draft order.
Also missing is any embrace of the movement to allow US patients to import their medicines from Canada or other nations with far cheaper prices. Nor are there provisions to take advantage of the government’s extensive legal rights to allow generic drug production and break the monopolies of over-priced patented drugs, especially the many critical drugs that were developed thanks to taxpayer funding. A majority of states are considering legislation to require increased drug price transparency and justification for large price increases, and some have passed such legislation — but the Trump administration’s draft order does not enhance transparency.
Instead, in an audacious example of blaming the victim, the draft order takes aim not at the industry whose profits rival those of banks and oil companies, but at low-income patients, both in the US and in developing countries. The proposal calls for restrictions on the 340B Drug Pricing Program, in which pharma corporations that benefit from the lucrative Medicaid market for their drugs are required in return to give some discounts to hospitals and clinics that serve low-income patients. And the order pushes for ramped-up trade pressure on developing countries that try to reduce the duration of drug monopolies that make medicines unaffordable for their citizens.
Not only are such measures mean-spirited, they would also be completely ineffective at reducing medicine prices for US patients. Rolling back limited drug price discounts for the poor would only increase revenue for pharmaceutical corporations that have a proven track record of directing their dollars into marketing, lobbying and breathtakingly high CEO pay, not lowered prices.
The argument that lower drug prices outside the US are hurting medicine research has been thoroughly debunked: High US prices have been proven to be fueling corporate profits, not industry research. Even if the Trump administration harbors legitimate concern that other countries are getting a free ride on US research investments, extended monopolies are not the answer. Knowledge Ecology International’s Jamie Love and others have proposed several ways the Trump administration could make increased medicine research contributions part of its ongoing trade negotiations with other nationsg — a far more effective way to spur increased research than hiking drug prices overseas.
As Public Citizen’s Peter Maybarduk says of the executive order, “The way to reduce medicine prices in the United States is to reduce them in the United States. Making medications more costly for the world’s poor won’t make them more affordable in the US, and won’t help Americans who are forced to choose between paying for their health care and paying the rent.”
But making medications even more expensive than they already are is precisely what Big Pharma wants. And President Trump appears determined to give it to them, all promises to the contrary be damned.
Truthout Is Preparing to Meet Trump’s Agenda With Resistance at Every Turn
Dear Truthout Community,
If you feel rage, despondency, confusion and deep fear today, you are not alone. We’re feeling it too. We are heartsick. Facing down Trump’s fascist agenda, we are desperately worried about the most vulnerable people among us, including our loved ones and everyone in the Truthout community, and our minds are racing a million miles a minute to try to map out all that needs to be done.
We must give ourselves space to grieve and feel our fear, feel our rage, and keep in the forefront of our mind the stark truth that millions of real human lives are on the line. And simultaneously, we’ve got to get to work, take stock of our resources, and prepare to throw ourselves full force into the movement.
Journalism is a linchpin of that movement. Even as we are reeling, we’re summoning up all the energy we can to face down what’s coming, because we know that one of the sharpest weapons against fascism is publishing the truth.
There are many terrifying planks to the Trump agenda, and we plan to devote ourselves to reporting thoroughly on each one and, crucially, covering the movements resisting them. We also recognize that Trump is a dire threat to journalism itself, and that we must take this seriously from the outset.
Last week, the four of us sat down to have some hard but necessary conversations about Truthout under a Trump presidency. How would we defend our publication from an avalanche of far right lawsuits that seek to bankrupt us? How would we keep our reporters safe if they need to cover outbreaks of political violence, or if they are targeted by authorities? How will we urgently produce the practical analysis, tools and movement coverage that you need right now — breaking through our normal routines to meet a terrifying moment in ways that best serve you?
It will be a tough, scary four years to produce social justice-driven journalism. We need to deliver news, strategy, liberatory ideas, tools and movement-sparking solutions with a force that we never have had to before. And at the same time, we desperately need to protect our ability to do so.
We know this is such a painful moment and donations may understandably be the last thing on your mind. But we must ask for your support, which is needed in a new and urgent way.
We promise we will kick into an even higher gear to give you truthful news that cuts against the disinformation and vitriol and hate and violence. We promise to publish analyses that will serve the needs of the movements we all rely on to survive the next four years, and even build for the future. We promise to be responsive, to recognize you as members of our community with a vital stake and voice in this work.
Please dig deep if you can, but a donation of any amount will be a truly meaningful and tangible action in this cataclysmic historical moment.
We’re with you. Let’s do all we can to move forward together.
With love, rage, and solidarity,
Maya, Negin, Saima, and Ziggy