WASHINGTON -- Democratic presidential candidate Hillary Clinton will outline a set of policies Tuesday she says will help make prescription drugs more affordable as escalating prices cause rising anxiety among American consumers.
Clinton's plan, a summary of which her campaign provided to reporters Monday evening, mostly represents steps long advocated by Democrats, including giving Medicare the authority to negotiate bulk discounts from pharmaceutical companies. Drug prices and overall national spending on prescriptions have risen in recent years, and a poll last month showed more than 70 percent of Americans think these medicines are too costly.
At an event in Des Moines, Iowa, on Tuesday, Clinton plans to defend the Affordable Care Act against Republican criticisms and pledge to protect and build upon the historic health care reform law enacted by President Barack Obama that remains the subject of intense political dispute.
But Clinton also will symbolically be distancing herself from one aspect of Obamacare by embracing policies targeting the prescription drug industry. Obama and Senate Democrats courted pharmaceutical companies when moving the Affordable Care Act through Congress in 2009 and 2010, and pledged to steer clear of Medicare price negotiation and other policies they opposed in exchange for the industry's political and financial support for the health care reform push.
Clinton, who served in the Senate at the beginning of the health care debate and later joined Obama's cabinet as secretary of state, will call for several policies specifically enjoined by the deal between the White House, then-Sen. Max Baucus (D-Mont.) and the Pharmaceutical Research and Manufacturers of America, an industry trade group.
That detente between Democrats and Big Pharma was a departure from their previously adversarial relations, and may be coming to an end with Obama's presidency winding down. Sen. Bernie Sanders (I-Vt.), Clinton's chief rival for the Democratic presidential nomination, introduced legislation earlier this month that includes many of the same ideas Clinton will promote on the campaign trail.
In addition to lifting the George W. Bush-era ban on Medicare setting prices for medicines the way it does for other medical products and services, and requiring larger rebates to Medicare, Clinton will advocate allowing lower-priced medicines to be imported from Canada and other countries with national health programs that pay lower prices for drugs than American patients do, and speeding lower-cost generic versions of so-called biologic drugs to the market.
The Clinton plan's other elements include establishing monthly limits on out-of-pocket costs for patients with serious and chronic ailments who need expensive medicines, an approach modeled on new laws in California, Maine and other states. Clinton also calls for scaling back tax benefits for drug makers, hastening Food and Drug Administration reviews of generic drug applications, and forbidding "pay-for-delay" deals where brand-name drug companies give money to generics makers that then agree not to compete against them.
The prescription drug industry has steadfastly opposed reforms like those promoted by Clinton and Sanders, as have Republicans, making the chances any would be enacted into law remote -- even if a Democrat wins the White House -- because the GOP is expected to retain control of Congress.
Ire among patients and medical providers over drug prices is being fueled by a variety of factors, starting with the longstanding reality that Americans pay higher prices for drugs than citizens of other rich nations that make up the Organization for Economic Cooperation and Development, mostly because these countries operate national health care systems.
More acutely, a drumbeat of news about high and rising drug costs has gotten the public's attention, and the additional expense was a main reason why a historic slowdown in national health care spending growth began to reverse last year.
On Monday, Clinton called attention to what she called "price gouging" by Turing Pharmaceuticals, which The New York Times reported Sunday increased the price of a drug to treat an infection suffered by AIDS and cancer patients from $13.50 a pill to $750. The price hike reflects an increasingly common practice in the drug industry to suddenly charge significantly more for old drugs for which there is no competition. The past several years also have seen the emergence of potent new medicines to treat Hepatitis C and high cholesterol that can cost as much as $1,000 per pill.
The drug price increases coincide with a trend in the health insurance industry to design benefit plans that require patients to pick up larger shares of their medical costs out of pocket, especially for the most expensive prescriptions.