Duck and cover

Why biopharma is taking the risky approach of waiting for Trump to focus elsewhere

Biopharmaceutical industry CEOs and lobbyists tell BioCentury they have settled on a duck and cover strategy for coping with President-elect Donald Trump’s frontal attacks on the industry’s pricing policies and global supply chains.

The idea is to avoid antagonizing Trump by directly responding to him or launching an aggressive public defense, while quietly shoring up alliances with lawmakers whose votes would be needed to implement the most drastic drug price-control proposals.

The strategy is based on the untested assumption that Trump is more interested in controlling the news cycle than in controlling drug prices.

To succeed, the industry will need to avoid high-profile pricing controversies that could provoke the tweeter-in-chief, and solidify its support in Congress.

It would be easy, however, for advocates for healthcare sectors that want to deflect the limelight to generate headlines about drug pricing. Payers could, for example, highlight the cost to families and the healthcare system of the spinal muscular atrophy (SMA) drug Spinraza nusinersen which Biogen Inc. priced at a wholesale acquisition cost (WAC) of $750,000 for the first year of treatment and $375,000 for subsequent years.

“We’re going to start bidding and we’re going to save billions of dollars over a period of time.”

President-elect Donald Trump

The strategy is also risky because conservative Republicans, the industry’s most stalwart allies, appear to be as afraid of Trump and unsettled by his unpredictability as corporate CEOs. If push comes to shove, there can be little doubt that Republicans would throw pharma under the bus to save their own skins.

Industry will also have to come to an accommodation with the HHS secretary and CMS administrator, who will have powerful levers to pry money from pharma’s pockets, and incentives to pull them to help pay for whatever will replace the Affordable

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