WASHINGTON — Former President Trump is backing off his support for a controversial drug pricing plan that struck fear into the hearts of pharmaceutical executives during his first term.
Trump in 2020 signed an executive order to make sure that Medicare didn’t pay more for prescription drugs than other developed countries. The aggressive policy could have slashed more than $10 billion per year from the pharmaceutical industry’s bottom line. The Biden administration ultimately rescinded the policy following a court order that stopped the program from going into effect.
In June 2023, Trump’s campaign released a video and statement indicating that the policy could make a comeback during a second Trump term, and said that, “On Day One, President Trump will sign an Executive Order to end global freeloading on American consumers once and for all.”
That is no longer the case, according to a statement by a Trump campaign spokesperson.
“There is no push to renew the most favored nations drug pricing policy. President Trump has promised to lower drug costs for Americans, like he did in his first term,” a Trump campaign spokesperson said in an email to STAT on Friday. The campaign video on the topic has been removed from the campaign’s website, though a transcript and press release remains.
That’s a significant pivot from the position the campaign took last summer, which explicitly stated that “the United States government will tell Big Pharma that we will only pay the best price they offer to foreign nations.”
While Trump may be abandoning this specific drug pricing proposal, he’s not necessarily going easy on the pharmaceutical industry.
“President Trump is extremely aware of the healthcare struggles our country is facing from the rise of chronic childhood illnesses to the high price of healthcare and insurance that hardworking families simply cannot afford,” Karoline Leavitt, the Trump campaign’s national press secretary, wrote in an email.
“By increasing transparency, promoting choice and competition, and expanding access to new affordable healthcare and prescription drug options, President Trump will make healthcare affordable again,” Leavitt said, using language pulled directly from the Republican party platform’s one-paragraph section on health care policy.
The statement echoes Robert F. Kennedy Jr.’s rhetoric suggesting the food and pharmaceutical industries have led to a rise in chronic illness. In joining the Trump transition team, Kennedy has pitched himself as a public health guy and tried to distance himself from the anti-vaccine rhetoric that made him famous — and his ideas are clearly seeping into the campaign.
The change in Trump’s position on the most favored nations policy was first reported by Inside Health Policy.
Leavitt pointed to another Trump campaign proposal to create a presidential commission “of independent minds who are not bought and paid for by Big Pharma” to investigate a rise in chronic illness.
Trump also proposed banning regulators from taking jobs with companies “they deal with and regulate, such as Big Pharma.” Trump in his last administration hired former pharmaceutical company executives for prominent health care positions.
Otherwise, the Trump campaign has not provided details about measures that would lower drug costs for consumers. He did spar with President Biden over who should get credit for capping out-of-pocket costs for seniors that use insulin at $35 per month (Biden’s proposal was more far-reaching, and enshrined in law instead of just regulation).
While in office Trump pursued a number of regulations to pass drugmaker discounts directly to patients, authorize the importation of prescription drugs, and regulate how community health centers use drug discounts that fizzled before they could be implemented. Democrats under Biden, by contrast, passed a drug pricing reform law that codified penalties for drugmakers that hike prices faster than inflation, gave the Medicare program authority to negotiate prices for some drugs, and capped pharmacy drug costs for seniors.
The idea that the pharmaceutical industry is freeloading is one that Trump returned to frequently during his first term, and his proposals got more harsh on the industry as his tenure went on. Some industry observers aren’t convinced he’s fully abandoned it forever.
“In our view, international drug reference pricing is way too instinctual for Trump to close the door on any potential approach to applying the concept in the US,” consultants Rob Smith and Kim Monk at the consulting firm Capital Alpha Partners wrote in a note to clients.