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Dispatch from NCHC Forum

The National Coalition on Health Care held a forum on Capitol Hill Thursday where four distinguished panelists discussed their vision for what lies ahead in 2017 on the issue of prescription drug prices. While the official subject was drugs, the conversation inevitably included speculation on the fate of the Affordable Care Act.

The forum kicked off with a presentation from Chuck Shih, Senior Officer of the drug spending research division at Pew Charitable Trusts. Mr. Shih, an expert on specialty drugs, explained how the high price of specialty drugs is driving increased drug spending, which is in turn driving up the cost of health care at an increased rate. (Specialty drugs are not the only problem, but their sky-high price increases the magnitude of the problem.)

Mark Merritt, CEO of the Pharmaceutical Care Management Association (PCMA), the PBM lobby, gave his pitch about PBMs as a cost-saving force. The CPPC openly disagrees with the assertions of PCMA and PBMs that their practices save consumers money. Research shows that PBMs, through lack of choice or transparency and rampant conflicts of interest, inflate the price of drugs and cause enormous waste.

Chip Davis, CEO of the Generic Pharmaceutical Association (GPhA), framed his vision for how to tackle drug prices in a very interesting way. First, he cautioned that a lack of clear messaging around the drug price problem has caused voters and members of the media to conflate conduct from branded drug companies and generic companies. He then explained the way he envisions approaching tackling high drug prices. If there was a magic bullet, he said, we would have found it already. We now have to pause and say, "We are here. Where do we go from here?"

Mr. Davis's point is much-needed in our current political climate. We have watched Congress excoriate CEOs of pharmaceutical companies and it has not had any effect on the price of medications. We must take stock of our system, its institutional problems, and what proposed solutions are out there. Then we must move forward together with a coherent vision to apply to the whole market, not just one company whose conduct is currently in the news.

The last panelist was Alex Brill of the American Enterprise Institute, AEI. He spoke about FDA reform and specifically about patent issues relating to biologic drugs and their generic counterparts known as biosimilars. He stated that biosimilar entry has not been as robust as was envisioned by the Affordable Care Act, due to archaic regulatory schemes, anticompetitive conduct, and cost-benefit analysis. There is a chance to address these issues, however, when the Prescription Drug User Fee Act (PDUFA) comes up for renewal next year.

While many policy folks in Washington expected to be discussing the Clinton Administration's drug plan, rather than Trump and relitigating the Affordable Care Act, NCHC's forum was productive and illuminating. There is still promise relating to the issue of drug prices, particularly because PDUFA is a bill that must be discussed and passed, essentially no matter what.

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