All 50 states, the District of Columbia, and Puerto Rico have signed up their Medicaid programs to participate in President Trump’s pilot program to test most-favored nation pricing for some drugs.
Trump said they will have access to “most-favored nation” drug prices equal to what other countries pay for prescription drugs. The White House said the lower drug prices would lead to nearly $65 billion in Medicaid drug savings over the next decade.
However, the program is a charade, Peter Maybarduk, access to medicines director for Public Citizen, an advocacy organization, said in a statement.
“Here’s the reality Americans are facing: high drug prices, rising health insurance premiums, and restrictions on drug coverage,” Maybarduk said. “But Trump’s own health officials have explicitly stated that companies in these deals can charge ‘whatever price they want for their medicines in the U.S.’”
He said Big Pharma expects little to no financial impact from these short-term Medicaid deals.
“Instead, pharma companies and Trump appear to have worked together to offer minor concessions to avoid taking more meaningful action to lower prices,” Maybarduk said.
In response to a Public Citizen Freedom of Information Act request, or FOIA, the U.S. Department of Health and Human Services released two of the 27 confidential agreements between drug makers and the Trump administration. The agreements spell out the terms of Trump’s “most-favored nation” pricing deals, the lynchpin of Trump’s claims to have lowered Americans’ prescription drug prices.
The released agreements, including the first White House deal with Pfizer and Eli Lilly’s deal on GLP-1s, are heavily redacted, making it difficult to verify several of the Trump administration’s claims. But the unredacted text shows that President Trump exaggerated his achievements and that the deals expire at the end of his term, according to a Public Citizen analysis of the texts.
“Trump’s drug pricing deals are a mirage, designed to convince Americans that he’s taken significant action on drug pricing while creating minimal if any downside for Big Pharma,” he said. “The texts show Trump handing out favors to Big Pharma, undercutting his own models to lower prices, and throwing the support of the U.S. government behind corporate decisions to deny medicines entirely to other countries.”
The unredacted text includes dates, definitions, direct-to-consumer prices and agreements, and dispute resolution procedures, among other terms, and shows that:
- Lilly’s GLP-1s are carved out from discounts required of other drugs subject to most-favored nation agreements. If Novo received a similar carveout for the GLP-1s it produces, it could reduce potential savings from the GENEROUS Medicaid pilot program by $1.7 billion. (GENEROUS stands for GENErating cost Reductions fOr U.S. Medicaid.)
- In the Lilly text, the U.S. blesses drug makers discontinuing entirely the supply of a medicine to other countries, to manage their U.S. most-favored nation prices, a practice that threatens patients’ health.
- The public can’t rely on the administration’s previous representations as to the most-favored nation agreements. For example, Pfizer’s most-favored nation agreement states that its terms supersede the Center for Medicare and Medicaid Innovation’s GENEROUS model, which outlines how state Medicaid programs get most-favored nation pricing, if there are conflicts.
“The Trump administration continues to favor secrecy in these limited disclosures under FOIA today, which show its template for most-favored nation, in part, but black out the prices, product lists, and information needed to assess whether Trump accomplished anything of substance,” Maybarduk said.
