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What Is Holding Up Those Lower Prescription Drug Prices?

woman takes pills, could be abortion pills or vitamins

Earlier this week, HHS Secretary Alex Azar testified in front of Congress about drug prices and administration efforts to bring them down.

As everyone who followed the 2016 campaign knows, this has been a big focus for President Trump. Pharmaceutical companies don’t like it, because they fear he’s going to use the hammer of government to force them to change their pricing ways. But the president hasn’t done that; he’s stayed focused on more free market mechanisms, like using the bully pulpit, to try to force concessions from drugmakers. Unfortunately, people working on drug policy in his administration don’t seem to be singing from the same hymn sheet as the president.

This week, we got another taste of this. A month ago, probably spurred by some promise made or other comment from Azar—who happens to be the former president of drugmaker Eli Lilly, which doesn’t seem very interested in reducing its drug prices—Trump said that in “two weeks,” drug companies would announce “voluntary, massive” price cuts. Not only has that not happened, and again, it’s possible the president made the comment after being misinformed by people “working” the issue, now Azar, again the former president of a drug company, is saying this: "We are hitting July 1, that's a traditional time for drug price increases, and I hope they will exercise restraint as they come across this period."

Something tells me that, as we learned during the Obama administration, “hope” isn’t going to result in real-world changes people want to see.

Pretty much the only people in the administration who seem to be working hard to get prices down are the president, at least through his use of the bully pulpit, and FDA head Scott Gottlieb, who is trying to speed up the process of bringing drugs to market, which should also make them cheaper.

The rest of the administration has been doing things like punting for a fifth time on discounted drug ceiling price rules that they are obliged by law to set (and it’s worth noting that said discounted drugs under the 340b drug program, which I’ve written about before here, tend to benefit Trump voters).

If you’re wondering why the administration of a president who ran hard on the issue of bringing down drug prices isn’t really doing much in this arena—interventionist, free market or otherwise—it’s worth looking at the staffing. As is so often said in politics, personnel is policy.

And the Trump administration, probably feeling desperate for “experts” to counterbalance relative newbies and outsiders it brought into the White House and elsewhere, has hired a lot of ex-Big Pharma lobbyists, lawyers, and other employees. Obviously, there’s Azar. But there’s also Joe Grogan, who lobbied for Gilead Sciences for six years, and Daniel Best, who works on drug pricing for HHS and worked for Pfizer. And Lance Leggitt of HHS and Timothy Clark of HHS also lobbied or consulted for Big Pharma players.