Trump’s divide and conquer Part B plan
Trump using a divide and conquer approach to Part B drug plan
While its rollout was timed to provide Republicans with ammunition in the last-minute run to the mid-term elections, the Trump administration’s proposal to revamp Part B drug payments won’t go into effect until 2020, at the earliest.
The biopharma industry, which loathes both the specifics of the plan and the precedents it would set, has about a year to derail the White House effort or water it down. Most galling to the industry is the plan to create an international reference pricing scheme.
The politics of Part B drugs is framed by the nature of the products covered: drugs that are infused or injected under a physician’s supervision, usually in a doctor’s office or a hospital outpatient facility.
The ability of any administration to dramatically change the Part B reimbursement scheme depends on its ability to obtain the consent of at least two of the three sectors that are affected by the prices of Part B drugs: drug companies, physicians and hospitals.
Any of these sectors alone might not have the political power to prevail, but the combined strength of any two is sufficient to overpower the president.
The Obama administration’s attempts to remodel Part B were scuppered by this reality when lobbyists for physicians, hospitals and biopharma created a groundswell of opposition that led to a revolt by members of