Grassley on Drug Prices, Importation, and Innovation

Sen. Chuck Grassley

Stat’s wide-ranging interview with Sen. Chuck Grassley, chair of the Senate Finance Committee, is the talk of the healthcare Twitterati and getting a lot of well-deserved attention.

Here are three takeaways:

Keep a close eye on PDPRA.
Grassley is, not surprisingly, against Medicare for all as the antidote to high drug prices. Instead, the Iowa Republican instead talks up provisions the Prescription Drug Pricing Reduction Act (PDPRA) that he and  Sen. Ron Wyden, the ranking Democratic on the Finance Committee, have co-sponsored. The legislation would, among other things, establish a new cap of about $3,000 on out-of-pocket expenses for Part D beneficiaries and require drug manufacturers to pay rebates to the federal government if a drug price increase exceeds inflation-inflation caps, for short. You can find a good Brookings explainer of the PDPRA here. In response to a question about whether the inflation caps would be on a slippery slope to price controls, Grassley defends them as reasonable-and as necessary for PDPRA to get bipartisan support.

Related: How HIgh Drug Prices Affect Patients

Keep an eye on drug importation plans and legislation. 
The Trump administration laid out a plan in December that would states, drug wholesalers and pharmacies to import prescription drugs from Canada, although the timetable is uncertain. In the Stat interview, Grassley references his 2004 legislation that would have expanded importation from the EU and several countries. He also mentions his 2019 bill that would allow importation of prescription drugs from Canada-and that Democratic presidential hopeful, Minnesota Sen. Amy Klobuchar, is a co-sponsor. He taps the brakes some on importing biologics, though, voicing concern about “the safety and efficacy of importing biologics into the medicine cabinets of American patients.”

Watch how Republicans straddle the innovation/profits vs. prices divide.
Pharma and biotech have warned that lowering drug prices could kill off innovation. Grassley offers up a full-throated defense of Big Pharma profit motives: “The so-called ‘animal spirits’ of American ingenuity has launched new frontiers of scientific discovery and 21st century miracles and treatment.” But in his homespun, mixed-metaphor style, he also says that “runaway profits won’t amount to a hill of beans for Big Pharma” if the taxpaying public can’t afford to pay the high prices.