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President Trump Signs 4 Drug Pricing Executive Orders

Analysis  |  By Jack O'Brien  
   July 24, 2020

President Trump added that the administration would have a "complete" healthcare plan to present "very shortly."

President Donald Trump signed four executive orders Friday afternoon, including measures aimed at supporting the importation of prescription drugs from foreign countries and bringing Medicare prices in line with those found in other countries.

As part of the executive orders, federal community health centers will now be required to pass insulin and Epipen cost savings on to patients and states will be allowed to import prescription drugs from Canada and other countries.

The two remaining executive orders will require pharmacy benefit managers (PBM) to pass rebate discounts through to patients and will also implement the international pricing index (IPI) model to "end global freeloading" by requiring Medicare to purchase prescription drugs at the same prices paid by other developed nations.

Trump said that several pharmaceutical executives will be at the White House on Tuesday to discuss the executive orders and efforts to lower drug prices. He said that if talks are successful, the administration might not have to implement the "most favored nation" policy by August 24.

At a signing ceremony at the White House, Trump said the orders would lead to "massive reductions in drug costs."

"As we take these historic actions, we're joined by Americans who have already benefited from the steps my administration has taken to reduce the costs of healthcare and prescription drugs," Trump said. "Today's actions continue my administration's relentless drive to deliver better healthcare clause at a lower cost." 

Trump added that the administration would have a "complete" healthcare plan to present "very shortly," which came less than a week after he told Fox News he would sign a new healthcare plan.

Related: Trump Has Blessed States' Exploration Of Importing Drugs. Will It Catch On?

Friday's announcement is the culmination of more than two years of policymaking focused on lowering prescription drug prices.

In late November, Trump tweeted that he and Health and Human Services (HHS) Secretary Alex Azar would release a plan to allow states to import prescription drugs.

"Hard-working Americans don't deserve to pay such high prices for the drugs they need. We are fighting DAILY to make sure this HAPPENS..." he tweeted.

Related: President Trump Promises Drug Importation Plan Soon

In late December, Azar unveiled a two-pronged proposed rule that lays the groundwork to allow states and drug companies to import prescription drugs from Canada.

In May 2018, Vermont became the first state to allow wholesale drug importation from Canada. That decision came days after Azar called the idea of lowering drug prices by importing from Canada "just a gimmick," citing the small size of Canada's prescription drug market compared to the U.S.  

Related: Azar: Drug Importation May Not Be a Gimmick After All

Following the signing ceremony, healthcare stakeholders weighed in on the administration's latest push to address high prescription drug prices.

Rep. Lloyd Doggett, D-Texas, who serves as chairman of the House Ways and Means Health subcommittee, issued a statement calling the executive orders a deal for "Big Pharma, not patients."

"After 3 ½ years of tweets and bluster, Trump once again delays action to appease his pals at Big Pharma," the statement read. "Instead of real relief from prescription price gouging, Trump lowers prices for nobody this year. He offers only modest orders recycling dormant proposals and a previously rejected, Big Pharma-promoted rebate rule, which will only increase both premiums and government spending."

The Campaign for Sustainable Rx Pricing (CSRxP) issued a statement that the prescription drug rebate rule was a "Big Pharma bailout paid for on the backs of American seniors and taxpayers."

"After years of talking about holding Big Pharma accountable, the administration demonstrated a shocking deference to the will of the pharmaceutical industry today," Lauren Aronson, executive director of CSRxP, said in a statement. "The White House suggests it will only advance a most favored nation rule after allowing Big Pharma executives to propose an alternative, while moving forward with the Pharma-backed Rebate Rule and changes that would weaken the 340B program."

Similarly, Public Citizen, a progressive consumer rights advocacy group, was also critical of the executive orders, saying the measures fall "short of providing patients relief."

"There is very little chance any of these measures will be implemented this year," Peter Maybarduk, director of Public Citizen's access to medicines program, said in a statement. "While some of these proposals could help a limited number of people access insulin or EpiPens, they are pathetically small compared to the massive executive power Trump could use to make medicine affordable and available for all, if he were willing to stand up to Big Pharma."

Editor's note: This article has been updated to include commentary from The Campaign for Sustainable Rx Pricing, Public Citizen, and Rep. Lloyd Doggett, D-Texas.

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.

Photo credit: Topeka Kansas, USA, October 6, 2018 President Donald Trump at MAGA rally in support of Kansas Secretary of State Kris Kobach who is the Republican candidate for governor. / Editorial credit: mark reinstein /

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