pHoto of Pharmacist handing medication to customerAllergy & Asthma Network, the leading patient education and advocacy nonprofit, is pleased to see the Trump Administration take action to reduce drug prices.

On July 24, President Trump signed a series of executive orders, including one designed to make epinephrine auto-injectors more affordable for low-income patients and another that eliminates drug discount “kickbacks” to pharmacy benefit managers.

Epinephrine Auto-Injectors

According to the executive order, “recent increased competition is helping drive prices down. Nevertheless, the price for some types of injectable epinephrine remains more than $600 per kit.”

Despite commercial insurance and federal programs such as Medicare and Medicaid, “many Americans still struggled to purchase these products,” the executive order reads.

The executive order directs Federally Qualified Health Centers (FQHC) to pass on discounts received from drug companies to low-income Americans who have a high cost-sharing requirement for epinephrine, have a high unmet deductible or have no health insurance.

Pharmacy Benefit Managers (PBM)

This executive order aims to reduce the role pharmacy benefit managers play in determining drug costs, including for medications prescribed to asthma and allergy patients.

“These middlemen … negotiate significant discounts off of list prices, sometimes up to 50% of the cost of the drug,” the executive order says. “Medicare patients, whose cost sharing is typically based on list prices, pay more than they should for drugs while the middlemen collect large ‘rebate’ checks.”

The executive order removes protections for “kickbacks” to pharmacy benefit managers and helps ensure that available discounts and rebates are passed on to the patient at the point of sale.

International Reference Pricing Index (IPI)

One key concern with the executive orders is with the International Reference Pricing Index. Questions remain who, when, where, what and how this would impact patients. The implementation plan here is key and in other countries, this type of approach has actually backfired by limiting access to care while slowing innovation in drug discovery.

It remains unclear when or if these executive orders will take effect. Nevertheless, Allergy & Asthma Network is pleased to see these key issues addressed on the federal level. The Network continues to work at the state and federal levels to address access to care and expand affordable treatment options for patients. Central to our work is addressing health disparities to bring forth equitable healthcare for all.

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