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Congress won’t adopt Pelosi’s price controls, but it may revamp Medicare Part D

The endgame on drug pricing could be a deal to restructure Medicare Part D

The fate of drug pricing legislation, and the fortunes of American patients and biopharmaceutical companies, hinge on calculations five politicians will make over the coming 100 days. If leadership in the House and Senate and President Donald Trump can find common ground, it is most likely to be centered on changes to Medicare that would free patients from the threat of crippling drug expenses, and that require drug companies to increase their financial contributions to the program.

The first step will be debate over the Lower Drug Costs Now Act of 2019 (H.R. 3), released on Sept. 19 by House Speaker Nancy Pelosi (D-Calif.), which seeks to set drug prices paid by Medicare and commercial payers based on an international reference pricing scheme. The bill will almost certainly pass the House and then die on arrival at the Senate.

Next, while Republicans are barring the door to Part D price-setting, the Senate will sort through its own drug pricing proposals.

A bill championed by Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.), the Prescription Drug Pricing Reduction Act (PDPRA), will be in the mix, as will the less contentious bipartisan Lower Health Care Costs Act (S. 1895).

S. 1895, which the Health, Education, Labor and Pensions

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