President Donald Trump signed four executive orders on Friday designed to significantly lower prescription drug prices for Americans, including insulin and epinephrine.
The directives to the secretary of Health and Human Services (HHS) will “[e]nd a shadowy system of kickbacks by middlemen that lurks behind the high out-of-pocket costs many Americans face at the pharmacy counter,” the department announced Friday, and said they will provide Americans more options on purchasing the drugs.
During the signing ceremony on Friday, the president said that the high price of insulin and EpiPens have cut off low-income people in “desperate” need of the treatments.
“The four orders I’m signing today will be on the prescription drug market in terms of pricing and everything else to make these medications affordable and accessible for all Americans,” said Trump, surrounded by health care professionals. “The first order will require federal community health centers to pass the giant discounts they received from drug companies on insulin and EpiPens directly to their patients. You know insulin became so expensive people weren’t able to use it. They desperately needed it.”
“We have it to a level that you’re not going to believe,” he continued. “EpiPens — likewise you have been hearing horrible stories about EpiPens over the last six or seven years, horrible, horrible, horrible increases for where they went to almost nothing to massive amounts of money. We’re changing that right now.”
“Under this order,” Trump added, “the price of insulin for affected patients will come down to just pennies a day, pennies a day from numbers that you weren’t even able to think about. It’s a massive cost savings.”
Trump said providers “should not be receiving discounts for themselves while charging their poorest patients massive full prices.”
Along with the order ending the “shadowy system of kickbacks by middlemen,” another order will allow states, wholesalers, and pharmacies to offer “safe and legal importation of prescription drugs from Canada and other countries where the price for the identical drug is incredibly lower,” Trump highlighted.
“It is a difference like you would not believe — 70%, 80%, 90%, 30% — but massively lower than the identical drug made in the same plant, same factory. Same exact drug, same everything, same box, same pill, and yet, it’s 50, 60, 70% lower,” he said.
Trump boosted the fourth executive order as the “granddaddy of them all,” ending “global freeloading on the backs of American patients and American seniors.”
“For decades our citizens have paid the highest prices for drugs, prescription drugs, anywhere in the world, and it is not even close,” he said. “Foreign nations have paid vastly less for the exact same drug again and the exact same box from the exact same plant, from the exact same company. They would pay 10%, 20%, 30%. What our people are paying a pill that would sell for one dollar in certain countries.”
“This means that Americans are funding the enormous cost of drug research and development for the entire planet,” Trump continued. “We are bearing the entire cost of all of this. They are bearing none. They say that this is what we are going to pay. In some cases, it’s the socialist country. So we are paying to reduce drug prices in a socialist country. How does that work?”
Per the HHS website, below are the directives ordered by Trump to the HHS secretary:
- End a shadowy system of kickbacks by middlemen that lurks behind the high out-of-pocket costs many Americans face at the pharmacy counter. Under this action, American seniors will directly receive these kickback as discounts in Medicare Part D. In 2018, these Part D discounts totaled more than $30 billion, representing an average discount of 26 to 30 percent.
- Require federally qualified health centers who purchase insulins and epinephrine in the 340B program to pass the savings from discounted drug prices directly on to medically underserved patients. This will increase access to life-saving insulin and epinephrine for the patients who face especially high costs among the 28 million patients who visit FQHCs every year, over six million of whom are uninsured.
- Finalize a rule allowing states to develop safe importation plans for certain prescription drugs.
- Authorize the re-importation of insulin products made in the United States if the Secretary finds re-importation is required for emergency medical care pursuant to section 801(d) of the Food, Drug, and Cosmetic Act.
- Create a pathway for safe personal importation through the use of individual waivers to purchase drugs at lower cost from pre-authorized U.S. pharmacies.
- Take action to ensure that the Medicare program and seniors pay no more for the most costly Medicare Part B drugs than any economically comparable OECD country, ending foreign countries’ free loading off the backs of American taxpayers and pharmaceutical investments. This order takes effect in 30 days unless Congress acts.