Republican control of the White House and Congress erodes the possibility of federal action to control the price of prescription drugs, health policy experts say.
Instead, policymaking to address the spiraling drug costs likely will be done on the state level. Yet the Election Day defeat of a California ballot measure to rein in drug prices may make local lawmakers less inclined to pursue that model of tamping down on drug prices, too.
“The prospect for a broad measure at the federal level for doing something about pricing is probably zero,” said Dr. Walid Gellad associate professor of medicine and director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.
Although Trump has indicated support for giving Medicare the ability to negotiate drug prices, “what everyone thought was going to happen related to prescription drugs is just a lot less likely,” said Gellad.
Nearly 54 percent of Californians voted against Proposition 61, which would have pegged the state of California’s payments for prescription drugs to prices paid by the U.S. Department of Veterans Affairs. The measure — which helped fuel a nationwide debate over ways to alleviate drug price “sticker shock” over EpiPens and other lifesaving medications — drew support in early polls, but lost traction in the days before the election.
Gellad says states may continue their push for more transparency in how drugmakers price their medications, especially when it comes to price increases.
About 16 states considered some sort of proposal during the last legislative session to require manufacturers to disclose how they price their products or how much they spend on research and development, according to the National Conference of State Legislatures. Vermont’s proposal was signed by the Governor this past June.
New Jersey and Virginia next year will renew consideration of drug price transparency legislation that had been in play this year but did not secure passage, said Dick Cauchi, the Conference’s program director for health insurance, finance and pharmaceuticals.
But it’s too soon to tell whether other states where proposals stalled or were defeated will reintroduce drug price-related measures next year, he said.
“Based on the increased level of legislative interest in this year’s sessions, it would not be surprising to see similar measures filed when all 50 state (legislatures) convene for 2017,” Cauchi said. “By early January, this landscape may be much clearer.”
California state Assemblymember David Chiu, D-San Francisco, who supported Proposition 61 and wrote one of two failed bills to require more drug price transparency, said he’s considering whether to introduce new drug price legislation next year.
“The issue will not go away until Californians and our country have some relief from skyrocketing drug prices,” said Chiu.
He said a range of groups have been approaching him since before the election to talk about what next year’s drug price policy proposal could look like.
“Everything is on the table,” he said.
Proposition 61’s defeat wasn’t huge, “but it was enough,” said Ken Miller, associate director of the Rose Institute of State and Local Government at Claremont McKenna College.
The complex approach taken to drug price controls — linking them to VA prices — may have been a factor in its demise. And voters may have been won over by the organized and well-financed campaign to defeat it, Miller said.
“Prop 61 was facing an enormous amount of negative attack ads on television,” said Miller. “The history is, if there is a huge amount of ‘no’ money, then typically the ballot measure fails.”
The drug industry had raised by far the most opposition funding — over $109 million dollars — to defeat the measure, according to California Secretary of State records.
For 27-year-old Emily Taggart who voted early against the measure, Proposition 61 was just not the right time or policy to address prescription drug costs.
“It sound[ed] like it would be awesome if it worked, but … there were a lot of variables that weren’t addressed,” said Taggart, a supermarket clerk in the Sacramento area. She said the measure didn’t seem to address the problem of pharmaceutical companies being able to “jack up” prices.
A measure almost identical to the now-defeated California’s Drug Price Relief Act is on Ohio’s 2017 ballot. Local health care advocates in Ohio say they haven’t heard a lot about their state’s measure that was sponsored by the AIDS Healthcare Foundation based in Los Angeles.
“I’m still uncertain whether the policy is good from the standpoint of whether it can be implemented,” said Steve Wagner, executive director of the Universal Health Care Action Network of Ohio, a consumer advocacy group.
Wagner says most of what he has heard about the measure has been from opponents.
Emily Taggart said she may support a different proposal to rein in prescription drug costs if one were brought before her again.
“I’m sure [drug prices] will be on the ballot again,” said Taggart. “Once they think it through a little more.”