Finally there is a text available, and Trump’s Executive Order on international reference pricing is a lot less than promised. Does nothing for most people and nothing at all right now.
The operative parts of the Executive Order are limited to Medicare, thus leaving out about 84 percent of the population. The Section 3 on Medicare Part B reads as a reference to the widely panned and long delayed Medicare Part B demonstration project, with a few tweaks on the reference prices. The Section 4 on Part D kicks the can down the road, simply calling for “appropriate steps to develop and implement a rulemaking plan, selecting for testing,” something that is taking years for his Part B experiment.
Missing is any strategy for placing conditions on products where the federal government holds rights in inventions or data, or plays a role in funding trials.
The key operative parts are here:
Sec. 3. Payment Model on the Most-Favored-Nation Price in Medicare Part B. To the extent consistent with law, the Secretary of Health and Human Services shall immediately take appropriate steps to implement his rulemaking plan to test a payment model pursuant to which Medicare would pay, for certain high-cost prescription drugs and biological products covered by Medicare Part B, no more than the most-favored-nation price. The model would test whether, for patients who require pharmaceutical treatment, paying no more than the most-favored-nation price would mitigate poor clinical outcomes and increased expenditures associated with high drug costs.
Sec. 4. Payment Model on the Most-Favored-Nation Price in Medicare Part D. To the extent consistent with law, the Secretary shall take appropriate steps to develop and implement a rulemaking plan, selecting for testing, consistent with section 1315a(b)(2)(A) of title 42, United States Code, a payment model pursuant to which Medicare would pay, for Part D prescription drugs or biological products where insufficient competition exists and seniors are faced with prices above those in OECD member countries that have a comparable per-capita gross domestic product to the United States, after adjusting for volume and differences in national gross domestic product, no more than the most-favored-nation price, to the extent feasible. The model should test whether, for patients who require pharmaceutical treatment, paying no more than the most-favored-nation price would mitigate poor clinical outcomes and increased expenditures associated with high drug costs.