Grassley to test GOP on lowering drug prices

Sen. Chuck Grassley (R-Iowa) is giving Republicans an early test on their commitment to lowering drug prices.

Legislation sponsored by the Senate Finance Committee chairman and Democratic Sen. Amy Klobuchar (Minn.) would allow people to buy prescription drugs from approved pharmacies in Canada.

The bill is reigniting a long-simmering debate about drug importation, a proposal strongly opposed by the powerful pharmaceutical lobby.

{mosads}Despite Grassley’s support, the measure faces an uphill battle in the Senate, where the Iowa Republican has long fought to make inroads with skeptical Republicans. But intense public pressure on drug companies over escalating prices and support from the Trump administration could tip the scales.

In addition, a new House Democratic majority made rising prescription drug costs a pillar of their midterm platform and could put pressure on the Senate to act, especially with Grassley as a powerful ally.

“It’s helpful for Democrats to have a pretty powerful Republican,” said Juliette Cubanski, an associate director at the Kaiser Family Foundation. “With Democrats on board and a key Republican in the Senate, action may be more likely.”

High drug prices are a bipartisan concern, and politicians recognize the need for action. Yet Congressional Republicans have historically not been supportive of drug importation.

Sen. Mike Rounds (R-S.D.) said he doesn’t trust that other countries would have the same safety standards as the U.S.

“Unless we’ve got a case we’re able to look back through and make sure we’ve got the same safeguards coming from there, I’d be a little bit leery,” Rounds told The Hill.

Grassley’s new role as the chairman of the Finance Committee, which has some jurisdiction over health care, could give him more sway with his colleagues on drug pricing issues.

“We’ll have to take a hard look at [Grassley’s bill]. He’s chair of Finance now, so that means something,” said Sen. Pat Roberts (R-Kan.), a member of the Finance Committee.

“All of us are concerned about the latest increases in prescription drugs,” Roberts told The Hill. “The problem with that is if we do something, it could be very counterproductive as well. I’m glad he mentioned it, and we’ll probably have hearings on it.”

The most important person for Grassley to convince is Senate Health Committee Chairman Lamar Alexander (R-Tenn.), who has voted against importation in the past and whose committee has jurisdiction over drug importation bills.

Asked by The Hill if he would hold hearings or a markup on Grassley’s bill, Alexander was noncommittal, saying he would have to read it. Grassley told The Hill he had not yet spoken with Alexander about it.

Sens. Cory Booker (D-N.J.), Bernie Sanders (I-Vt.) and several other Democrats in the House and Senate also recently unveiled drug importation legislation that’s much more sweeping than the Grassley/Klobuchar bill.

Legalizing drug importation is a key Democratic policy, but the bipartisan nature of Grassley’s bill may mean he has more success than Democrats alone.

Sanders said the Democratic House could put pressure on the Senate.

“These guys are going to give us something and now our Republican colleagues here are going to have to tell their constituents back home why they do not support common sense legislation to lower the cost of prescription drugs,” he said.

Grassley, a proponent of free-market policies, has long been a champion of drug importation.

In 2017, Grassley, Klobuchar, and the late Sen. John McCain (R-Ariz.), urged former Secretary of Health and Human Services Tom Price to use statutory authority to fast-track the importation of prescription drugs from Canada.

Grassley and McCain made a similar request to former HHS Secretary Sylvia Matthews Burwell in 2015.

The Trump administration also has been exploring the idea of importing prescription drugs, albeit in a very limited fashion.

The Food and Drug Administration last summer formed a working group to examine ways to safely import drugs in cases in which there is a dramatic price increase for a drug produced by one manufacturer and not protected by patents or exclusivities.

HHS Secretary Alex Azar has been using importation as a threat to get drug companies to lower prices.

“All options are on the table,” including importation, Azar said last week. “We will continue with more regulatory and legislative proposals, and we will work with Democrats and Republicans, until we see list prices come down.

Supporters of drug importation think it could inject competition into the marketplace, and the idea enjoys broad support from the public.

A Kaiser Family Foundation poll from 2017 showed 72 percent of those surveyed thought Americans should be allowed to buy prescription drugs imported from Canada.

But the idea is fiercely opposed by the pharmaceutical industry, which argues imported drugs are unsafe.

“We agree with the administration that ensuring patients have access to needed medicines is crucial and that steps must be taken to address current challenges in accessing sole-source medicines, but importation of non-FDA approved medicines is not the solution,” the trade group Pharmaceutical Research & Manufacturers of America (PhRMA), said in a statement.