PHP168 - TRUMP’S PLANS TO REDUCE DRUG PRICES: FROM THE CAMPAIGN TRAIL TO AMERICAN PATIENTS FIRST

Abstract

Drug prices in the United States are the highest in the world, restricting access to the lower income population in the nation. President Trump campaigned heavily on the promise of reduction in drug prices. Objective of this review was to evaluate the promises made during Trump campaign and current achievements. A literature review was conducted through PUBMED, EMBASE, Media and grey literature to consolidate publications of Trump’s promises and achievements. Major campaign promises included repealing and replacing the Affordable Care Act (ACA), direct negotiation between Medicare and the pharmaceutical industry, importation of cheaper, foreign-manufactured drugs, and the stimulation of competition between insurance plans across state lines. Initial focus of Trump’s presidency has been on the ACA. The passing of Executive Order 13765 set out interim procedures in anticipation of repeal of ACA, potentially leading to higher insurance premiums. The Executive Order to Promote Healthcare Choice and Competition directs federal agencies to modify how ACA is implemented, also potentially increasing premiums for low-income Americans. The American Health Care Act was also passed, partially affecting ACA, along with the Tax Cuts and Jobs Act of 2017 the individual mandate requiring individuals to have health insurance. American Patients First, Trump’s May 2018 drug pricing plan, reiterates the need to stimulate competition, allow for better negotiation, but also suggests creating incentives to lower list prices and reducing out-of-pocket spending to reduce drug prices. To date President Trump has not delivered on his early promises to reduce drug prices. He has focused on signing executive orders to dismantle the ACA. If enough legislative change is accomplished to implement his promises, the effects on the pharmaceutical industry could be direct, yet minimal as his promises essentially allow for a shift in the burden of cost, unless Medicare can directly negotiate with manufacturers.