The pharmaceutical lobby is mounting a last-ditch effort to add a measure to an opioid abuse bill that would block an increase to the portion of a drug’s cost the industry must cover under Medicare, sources tell the Washington Examiner.
The Pharmaceutical Research and Manufacturers of America is under pressure to fix the so-called “doughnut hole” after the influential industry group failed to add a measure addressing the issue to a prior bill to fund the Department of Health and Human Services.
PhRMA, as the group is commonly known, has been advocating for a package that would roll back a measure included in the February government spending bill that increases in 2019 the industry’s payment obligations in the Medicare Part D program. The provision would obligate pharmaceutical companies to provide a 70 percent discount on drugs offered in the Medicare Part D program, and PhRMA is trying to lower that discount to 63 percent before the increase takes effect.
The provision would be paired with updated legislation that would make it more difficult for pharmaceutical manufacturers to abuse a safety program at the Food and Drug Administration.
The Senate bill intended to help address the raging opioid epidemic in the U.S. is viewed as one of the last potential packages in 2018 that could include such a measure. The chamber may vote on the opioid legislation as soon as next week, after which a conference is expected to merge the Senate version with a House-passed bill.
The package under consideration would also include legislation known as the CREATES Act that would address situations when a brand-name drug company refuses to provide thousands of product samples a generic company needs to gain FDA approval. PhRMA’s backing of such a proposal marks a dramatic turn from the industry’s previously staunch opposition to the bill.
The group is also seeking a two-year delay of a $1,200 increase in out-of-pocket spending for beneficiaries on Medicare Part D, set to take effect in 2020, a provision that lobbyists say was included to help sweeten the deal for Democrats who are not inclined to give the industry a victory.
