Senior Democrat outlines new drug pricing plan as talks drag on

Senate Finance Chair Ron Wyden on Tuesday outlined a proposal for curbing prescription drug prices as pressure ramps up on Democratic lawmakers to use the reforms to pay for other priorities in a massive infrastructure package.

The new framework, which Wyden has discussed for months with members of his influential committee and Democratic leadership, proposes building on the bipartisan plan he and Sen. Chuck Grassley (R-Iowa) offered last Congress that never came up for a floor vote due to GOP leaders' opposition. It would also include provisions similar to the House’s landmark drug pricing bill, H.R. 3 (117), that would empower Medicare to negotiate with pharmaceutical companies and apply those lower prices across other public and private insurance programs.

The Wyden plan comes as drug pricing talks in Congress remain uncertain. A group of House Democratic moderates have raised concerns over government negotiations, casting in doubt Speaker Nancy Pelosi's pledge to include her drug pricing bill in infrastructure legislation.

Wyden told POLITICO he’s been talking to Republican lawmakers and Democratic colleagues close to drugmakers to build support for his proposal, arguing it would not hamper research and development, as critics of pricing reforms argue.

“To me, the real key here is what I’ve been focusing on with members: showing that the affordability of medicine and the importance of encouraging scientific innovation and breakthroughs are not mutually exclusive,” the Oregon Democrat said. “It’s possible to do both.”

A senior Democratic aide noted that Wyden's blueprint doesn't represent a consensus among Democrats on the committee, some of whom remain skeptical of the effort. The document is also light on details; for instance, it doesn't explain the mechanism for drug pricing negotiations, sidestepping a heated debate about using the prices other countries pay as a baseline.

"This is just a starting point so we can go to offices and ask: What do you like about this? What do you not like about this?" the aide said. "It's something to jump start a conversation."

Though members in both parties have expressed interest in addressing drug prices, Democratic lawmakers are assuming they would have to pass any change through a party-line reconciliation vote. Grassley on Tuesday dismissed Wyden's new blueprint and argued that their narrower effort from last Congress was the only plan that could gain enough support to advance.

"I don't see why you'd waste your time on anything else," he said. "Maybe he has to do that to satisfy the progressives in his party, but he worked so hard and I don't know why he'd want to try to redo something that's got such bipartisan support."

Wyden's efforts could intersect with separate bids to incorporate more health policy changes in a sweeping infrastructure package. Senate Budget Chair Bernie Sanders (I-Vt.) said Monday he's drafting a budget resolution that will include not only direct government drug price negotiations but an expansion of Medicare to cover dental, hearing and vision benefits.

Though aides have noted that the budget language is non-binding and individual committees like Finance will ultimately craft the specific policies, Sanders says he’s been talking to the Finance Committee “all the time” and believes all 50 Democrats will ultimately support the measures. He also noted the drug pricing provisions could save hundreds of billions of dollars that could offset the cost of other priorities.

“Like everything else there are going to be fights over the details, but I’m confident we’re going to go forward effectively,” Sanders said.

Progressive groups like Public Citizen cheered the release of Wyden's proposal Tuesday but stressed that lawmakers in the coming weeks will need to confront tough questions like how broadly to require drug pricing negotiations and how to penalize drugmakers that don’t comply.

"The details will matter," Public Citizen president Robert Weissman said.
Some analysts said they were skeptical the effort will get off the ground.

"We see the lack of details as a sign that consensus among Dems on drug pricing is a long way off," Cowen Washington Research wrote in a new memo.

Democrats’ thin legislative majorities gives them little room to maneuver, and some moderate lawmakers have expressed concern about aggressive reforms, making the passage of any drug price reform an uphill battle. Sen. Bob Menendez (D-N.J.), whose state is home to numerous drug companies, has said the industry shouldn’t be a "piggy bank" for infrastructure legislation.

“We keep taking money from the pharmaceutical industry and then we never see the reduction in the cost of prescription drugs. How is that solving the problem?” Menendez said. “If all we’re doing is getting a revenue source from the industry without reducing the drug costs of consumers, the we haven’t gotten it right.”

House Budget Chair John Yarmuth (D-Ky.) last week noted the challenge of drafting something the entire caucus can agree on.

“There's zero margin,” he said. “So essentially, everybody's in position to sabotage whatever we're doing.”