MARY LOUISE KELLY, HOST:
Today President Trump laid out his plan to deal with the high and still-rising prices of prescription drugs. He called it the most sweeping proposal in history, and he promised people will see results soon.
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PRESIDENT DONALD TRUMP: We will have tougher negotiation, more competition and much lower prices at the pharmacy counter. And it'll start to take effect very soon.
KELLY: The president spoke in the Rose Garden. And as he spoke, the Department of Health and Human Services released what it is calling a blueprint for lowering drug costs, a blueprint that NPR health policy correspondent Alison Kodjak has been poring over. And she is here now to tell us all about what's in it. Hey, Alison.
ALISON KODJAK, BYLINE: Hey, Mary Louise.
KELLY: So what's in the plan?
KODJAK: So the president called it sweeping, and he's right. It touches on everything from the drug approval process, the patent system, the incentives that drive the drug prices higher and even how Medicare works and foreign trade. And it tries to lower prices for individuals but also addresses the overall cost of prescriptions to the whole system, to the economy. But a lot of what's laid out are just ideas. And, you know, they're good or bad ideas, but they're ideas. They're not concrete proposals. They're things the administration wants to study or ask for feedback on.
KELLY: Are there any concrete proposals in here? I mean, are there specific ideas for how they're going to lower drug prices?
KODJAK: There are a few. There's a lot of very wonky ones that are, like, how Medicare pays for things. But there's, like, one specific one that would allow senior citizens on Medicare to get their generic drugs for free. And so that would cut costs to the senior citizens but also to the system because they would be more likely to buy the generic drug. There's one more that would require drug companies in all those ads we see on TV advertising drugs - they would have to actually include their price, which might drive...
KODJAK: ...Them to sort of say, oh, maybe we shouldn't give it a thousand dollars a pill for this drug. So the idea there is to, you know, shame them I guess into lowering their prices.
KELLY: And meanwhile, drug ads get even longer on television...
KODJAK: (Laughing) That would be funny.
KELLY: ...With more disclosures.
KODJAK: Yeah. And then there's a bunch of proposals that are aimed at middlemen in the pharmaceutical industry. And the president really seemed to have his sights on that one. Here is what he said.
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TRUMP: We're very much eliminating the middlemen. The middlemen became very, very rich, all right?
TRUMP: Whoever those middlemen were - a lot of people never even figured it out - they're rich. They won't be so rich anymore.
KELLY: All right, Alison Kodjak, help us figure out who these middlemen were and what exactly the Trump administration wants to do to make them less so.
KODJAK: Yeah, so they're, like, what are called pharmacy benefit managers. These are the people like Express Scripts or CVS Caremark that implement your pharmacy program for your insurance company or your employer. But a lot of people say they play both sides. They negotiate rebates, and then they take a share of it. So it's in their interest to see drug prices higher. So what Health and Human Services Secretary Alex Azar said after the president's speech was they want to eliminate the whole rebates system, and that would really change how drug prices are - how drugs are sold across the country.
KELLY: You're telling me a lot about what the administration wants to do, what the administration might do.
KELLY: How likely that all of this is going to come to pass and how soon?
KODJAK: Yeah, so some of this stuff was in the president's budget, and they need Congress to pass it. So it's unclear what will happen there. And a lot of these, like I said, are - they're asking for information. And as Secretary Azar said, many of these ideas may take many years to implement.
KELLY: NPR's Alison Kodjak, thanks so much.
KODJAK: Thanks, Mary Louise.
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