A battle is brewing over letting Medicare negotiate over drug prices, a power some doctors say is needed to curb high drug prices and opponents argue is unnecessary.
Advocates say that providing Medicare negotiating power would lead to lower prices on breakthrough treatments, which could strain federal and state budgets if prices aren't reduced. The pharmaceutical industry and a healthcare transparency organization say it won't save money because private-sector organizations already negotiate for lower prices.
More than 100 cancer experts earlier this week called for policy reforms to combat rising prices for cancer drugs, some of which can cost $120,000 per year.
A study released by the advocacy group Public Citizen also found that Medicare pays much more than Medicaid or Veterans Affairs for brand-name drugs.
Public sentiment appears to support negotiating power for Medicare, as a recent poll from the Kaiser Family Foundation found that more than 80 percent of adults surveyed approved of the idea.
However, giving Medicare the power to negotiate for lower drug prices "definitely won't save any money," said Joel White, president of the Clear Choices Campaign, a coalition of high-profile groups such as AARP, insurance company Aetna and drug company Novo Nordisk.
Pharmacy benefit managers, who manage the prescription drug plans for insurers, already aggressively negotiate for health plans under Medicare's prescription drug program called Part D, White said Friday during a briefing sponsored by the Alliance for Healthcare Reform.
"Those [pharmacy benefit managers] and health plans are already negotiating the discounts and already being passed on to consumers," he said.
Medicare Part D charges a beneficiary for access to a prescription drug plan sponsored by a private insurer or pharmacy benefit manager approved by Medicare. The plan sponsor can negotiate with drug manufacturers and pharmacies for rebates or discounts, according to Public Citizen's report.
However, Medicare itself cannot negotiate for cheaper prices under federal law, and Public Citizen said that can lead to Medicare paying a lot.
"Numerous reports and scientific papers have demonstrated that, after taking into account the rebates obtained by plan sponsors, prescription drugs covered under Medicare Part D are priced at much higher levels than in other federal programs," the report said. Public Citizen and Carleton University compared Medicare spending with Medicaid and Veterans Affairs, which get bigger discounts from drug manufacturers.
Some Democratic lawmakers tried to give negotiating power to Medicare in 2007, but the legislation went nowhere.
Part of the problem was a damning report from the Congressional Budget Office that year which found negotiating power would have a "negligible effect" on spending.
The nonpartisan agency predicted that the government wouldn't have enough leverage to negotiate prices better than pharmacy benefit managers.
In fact, to really lower prices the federal government would have to go further.
"The authority to establish a formulary, set prices administratively or take other regulatory actions against firms failing to offer price reductions could give the [government] the ability to obtain significant discounts," according to a separate CBO report.
The pharmaceutical industry has said the policy prescriptions recommended by the cancer experts would "send a chilling signal to the market that risk-taking will no longer be rewarded," according to the trade group Pharmaceutical Research and Manufacturers of America.
The group also noted that pharmacy benefit managers already aggressively negotiate over prices.
Hampering innovation is a common defense used by the pharmaceutical industry to beat back concerns about drug prices.