Democrats see <a href="https://www.google.com/url?client=internal-uds-cse&amp;cx=006054055338965708568:09spwrlibei&amp;q=https://www.wionews.com/world/donald-trump-declines-to-set-united-states-uranium-production-quotas-235511&amp;sa=U&amp;ved=2ahUKEwjV7Ybf4rHjAhURA4gKHYngDqgQFjACegQIEBAC&amp;usg=AOvVaw0Igh2cu_eaVsR8edMUc62K">US President Donald Trump</a> becoming increasingly vulnerable to criticism about healthcare costs after the administration's decision to scrap a proposal to lower drug prices, and 2020 White House candidates are rushing to seize the spotlight on the issue.

The debate over the future of the American healthcare system has become a focal point of the Democratic presidential nominating contest.&nbsp;

As Trump has failed to make strides to remedy the problem, Democrats are becoming more vocal.

Some Democrats have been making big promises on healthcare, vowing to sweeping overhauls and complete government takeovers.

But even candidates like US Senators <a href="https://www.google.com/url?client=internal-uds-cse&amp;cx=006054055338965708568:09spwrlibei&amp;q=https://www.wionews.com/opinions/trumps-strong-stances-greatly-benefit-india-heres-how-234632&amp;sa=U&amp;ved=2ahUKEwjJlo3d47HjAhXQc3AKHdwKAOEQFjAAegQIABAC&amp;usg=AOvVaw34fN15vkSGEQUlRF2yS_MK">Bernie Sanders</a> and Elizabeth Warren, who would abolish private health insurance, are wading into the debate about lowering costs for consumers buying drugs in the current market.

Trump talked regularly about drug prices during his 2016 campaign but has failed so far to deliver the changes he promised.

On Thursday his administration scrapped one of its most ambitious proposals for lowering prescription medicine prices, backing down from a policy aimed at health insurers and raising the possibility of new measures focused on drugmakers.

The abandoned proposal would have required health insurers to pass billions of dollars in rebates from drugmakers to Medicare patients.

Drug prices directly affect consumers, making it a more pressing concern for voters than debates over the structure of the healthcare system, said Robert Blendon, a political scientist at Harvard University who researches public opinion on healthcare.

Blendon said Trump, having failed to broker any deals in Congress, made his drug price plan too complicated, and voters are unlikely to see him as having made any strides.&nbsp;

That is an opportunity for Democrats to offer their own effort at messaging.

A study Blendon produced earlier this year found that given a list of problems, nine out of 10 Americans chose the price of prescription drugs as an extremely important issue.

But voters' concerns do not extend to the stability or structure of government, with only 25% saying they are concerned about the stability of Medicare.

"Whoever gains anything politically out of this is going to have to talk about this (so that) it sounds like you understand," Blendon said.&nbsp;

"It really is a pocketbook issue."

On Thursday, US Senators Kirsten Gillibrand unveiled a plan to lower drug prices.&nbsp;

On Friday, Democrat Amy Klobuchar announced a plan to help lower the cost of pharmaceuticals purchased by seniors. Warren also has a Medicare pricing plan.

Sanders is heading to Canada later this month for an event to highlight the difference in the price of insulin.

Blendon said it was becoming obvious to candidates like Sanders that they cannot peg their entire healthcare message to arguing for a universal system.

"Medicare for all is not a top issue for older voters," Blendon said.

Klobuchar's proposal, which includes investing in research for a cure for Alzheimer's disease and improving the stability of Social Security, would allow the government to negotiate Medicare Part D costs, which cover prescriptions for seniors.

Klobuchar, a US senator from Minnesota, would also let people order prescription drugs from countries like Canada, proposal proponents say would lower costs.

Blendon said import changes are the most popular with voters, who fail to see how drugs from Canada or England are any more risky than ones made in the United States.

Democrats see US President Donald Trump becoming increasingly vulnerable to criticism about healthcare costs after the administration's decision to scrap a proposal to lower drug prices, and 2020 White House candidates are rushing to seize the spotlight on the issue.

Democrats see US President Donald Trump becoming increasingly vulnerable to criticism about healthcare costs after the administration's decision to scrap a proposal to lower drug prices, and 2020 White House candidates are rushing to seize the spotlight on the issue. The debate over the future of the American healthcare system has become a focal point of the Democratic presidential nominating contest. As Trump has failed to make strides to remedy the problem, Democrats are becoming more vocal. Some Democrats have been making big promises on healthcare, vowing to sweeping overhauls and complete government takeovers. But even candidates like US Senators Bernie Sanders and Elizabeth Warren, who would abolish private health insurance, are wading into the debate about lowering costs for consumers buying drugs in the current market. Trump talked regularly about drug prices during his 2016 campaign but has failed so far to deliver the changes he promised. On Thursday his administration scrapped one of its most ambitious proposals for lowering prescription medicine prices, backing down from a policy aimed at health insurers and raising the possibility of new measures focused on drugmakers. The abandoned proposal would have required health insurers to pass billions of dollars in rebates from drugmakers to Medicare patients. Drug prices directly affect consumers, making it a more pressing concern for voters than debates over the structure of the healthcare system, said Robert Blendon, a political scientist at Harvard University who researches public opinion on healthcare. Blendon said Trump, having failed to broker any deals in Congress, made his drug price plan too complicated, and voters are unlikely to see him as having made any strides. That is an opportunity for Democrats to offer their own effort at messaging. A study Blendon produced earlier this year found that given a list of problems, nine out of 10 Americans chose the price of prescription drugs as an extremely important issue. But voters' concerns do not extend to the stability or structure of government, with only 25% saying they are concerned about the stability of Medicare. "Whoever gains anything politically out of this is going to have to talk about this (so that) it sounds like you understand," Blendon said. "It really is a pocketbook issue." On Thursday, US Senators Kirsten Gillibrand unveiled a plan to lower drug prices. On Friday, Democrat Amy Klobuchar announced a plan to help lower the cost of pharmaceuticals purchased by seniors. Warren also has a Medicare pricing plan. Sanders is heading to Canada later this month for an event to highlight the difference in the price of insulin. Blendon said it was becoming obvious to candidates like Sanders that they cannot peg their entire healthcare message to arguing for a universal system. "Medicare for all is not a top issue for older voters," Blendon said. Klobuchar's proposal, which includes investing in research for a cure for Alzheimer's disease and improving the stability of Social Security, would allow the government to negotiate Medicare Part D costs, which cover prescriptions for seniors. Klobuchar, a US senator from Minnesota, would also let people order prescription drugs from countries like Canada, proposal proponents say would lower costs. Blendon said import changes are the most popular with voters, who fail to see how drugs from Canada or England are any more risky than ones made in the United States.

Democrats take aim as Donald Trump abandons drug pricing plan

Global pressure on health spending is forcing the $1 trillion-a-year pharmaceutical industry to look for new ways to price its products: charging based on how much they improve patients&#39; health, rather than how many pills or vials are sold. 
 
In the United States, both parties are promising fresh action on drug prices whoever wins the White House. In Europe, economies are stalled, squeezing state health budgets. And in China and other Asian markets, governments are getting tougher with suppliers. 
 
Pricing drugs based on clinical outcomes is one way to ensure that limited funds bring the most benefits to patients now and pay for the most promising medical advances in future. Some experiments in pricing have already been made. 
 
But shifting the overall industry to a new model requires improvements in data collection and a change in thinking, say drug pricing experts. 
 
&quot;Eventually, we are going to get there,&quot; said Kurt Kessler, managing principal at ZS Associates in Zurich, which advises companies on sales and marketing strategies. &quot;But it is a long, tough slog because it&#39;s difficult to get the right data and agree on what the right outcomes are to measure.&quot; 
 
In the past, governments and insurers made room in their budgets for new drugs by switching to cheap generics as patents expired on older drugs. But today generics already account for nearly nine out of every 10 prescriptions in key markets like the United States, and fewer big drugs are going off patent. 
 
That leaves little headroom for pricey new medicines for cancer and other hard-to-treat diseases, even as they come to market in growing numbers. The US Food and Drug Administration has already approved 16 new drugs this year. 
 
Investors got a wake-up call on the issue last Friday when $10 billion was lopped off the market value of Novo Nordisk as the world&#39;s biggest diabetes firm warned of falling US prices. 
 
Pharmacy benefit managers administering US health plans are pushing back hard by excluding some drugs deemed too expensive - including Novo&rsquo;s - leading to a crunch in areas like diabetes, a disease that now accounts for 12 per cent of global healthcare spending. 
 
The Danish group has an unusually high exposure to the US market, but it is not alone in signaling tough times ahead. 
 
The chief executives of Novartis, Eli Lilly and GlaxoSmithKline have all warned recently that pricing will become increasingly challenging across the board. 
 
Accounting for 40 per cent of global drug sales, the fate of the US market is front and center in the minds of drug company executives, some of whom privately admit to preparing for a &quot;confrontational&quot; period in relations with politicians. 
 
Both Hillary Clinton and Donald Trump have suggested new measures to curb prices, including allowing imports from lower-cost countries, while individual US states, starting with Vermont, are working on transparency legislation that would require firms to disclose costs to justify drug prices. 
 
Novartis CEO Joe Jimenez believes drugmakers must develop value-for-money pricing models, like the performance-based deal the Swiss drugmaker recently struck with two US insurers for its new heart failure drug. 
 
Under that deal, payments for Novartis&#39; Entresto pill are to be calculated in future based on the proven reduction in the proportion of the insurers&#39; patients admitted to hospital for heart failure, not on the number of pills they consume. 
 
The aim is a flexible pricing system that rebates healthcare providers when a drug doesn&rsquo;t work as planned and charges more when it works well. 
 
Europe in vanguard 
 
Europe is in the vanguard of such moves. Britain agreed an early performance-based deal for a Johnson &amp; Johnson blood cancer drug back in 2007 and Italy also uses patient data to pay for cancer drugs based on actual patient responses. 
 
GSK CEO Andrew Witty sees this outcomes-based approach slowly becoming the norm in more disease areas and geographies. 
 
&quot;Whoever wins the election in the US, and also in Europe, we will see those conversations play out over the next few years,&quot; he told Reuters. &quot;I am not particularly expecting anything dramatic in 2017. I would say it is worth keeping an eye open for evolution of change, probably in &rsquo;18 and &rsquo;19.&quot; 
 
The pharmaceutical industry&#39;s European trade association is already discussing ways to shift to outcomes pricing, following price curbs in Germany that have caused some companies to pull products off the market, and effective rationing in Britain, where strict cost-effectiveness rules apply. 
 
Authorities in Asia&#39;s two biggest markets, China and Japan, are also intervening in new ways to cap runaway costs. 
 
Dani Saurymper, manager of the AXA Framlington Health fund, believes the issue is going to move up the agenda for investors, not least with the arrival of gene and cell therapies. These could cure diseases like haemophilia and certain cancers, but at a cost of hundreds of thousands or even $1 million a patient. 
 
&quot;Pay for performance is going to become much more relevant,&quot; he said. 
 
Still, the obstacles are formidable. Drug companies and healthcare providers will need to work together to develop systems that capture and prove a medicine&#39;s clinical value, ideally using computerized systems that are only just emerging. 
 
There are also potential legal pitfalls, given the need to establish clear-cut clinical outcomes for patients and determine how much of an effect should be attributed to the medicine or other healthcare inputs. 
 
&quot;Overall, it is the right direction but there are many practical difficulties,&quot; said Helen Roberts, a specialist in healthcare at law firm BonelliErede. &quot;There may well be legal challenges if there is disagreement as to whether an outcome has actually been achieved.&quot; 
 
(Reuters)

Global pressure on health spending is forcing the $1 trillion-a-year pharmaceutical industry to look for new ways to price its products

Global pressure on health spending is forcing the $1 trillion-a-year pharmaceutical industry to look for new ways to price its products: charging based on how much they improve patients' health, rather than how many pills or vials are sold. In the United States, both parties are promising fresh action on drug prices whoever wins the White House. In Europe, economies are stalled, squeezing state health budgets. And in China and other Asian markets, governments are getting tougher with suppliers. Pricing drugs based on clinical outcomes is one way to ensure that limited funds bring the most benefits to patients now and pay for the most promising medical advances in future. Some experiments in pricing have already been made. But shifting the overall industry to a new model requires improvements in data collection and a change in thinking, say drug pricing experts. "Eventually, we are going to get there," said Kurt Kessler, managing principal at ZS Associates in Zurich, which advises companies on sales and marketing strategies. "But it is a long, tough slog because it's difficult to get the right data and agree on what the right outcomes are to measure." In the past, governments and insurers made room in their budgets for new drugs by switching to cheap generics as patents expired on older drugs. But today generics already account for nearly nine out of every 10 prescriptions in key markets like the United States, and fewer big drugs are going off patent. That leaves little headroom for pricey new medicines for cancer and other hard-to-treat diseases, even as they come to market in growing numbers. The US Food and Drug Administration has already approved 16 new drugs this year. Investors got a wake-up call on the issue last Friday when $10 billion was lopped off the market value of Novo Nordisk as the world's biggest diabetes firm warned of falling US prices. Pharmacy benefit managers administering US health plans are pushing back hard by excluding some drugs deemed too expensive - including Novo’s - leading to a crunch in areas like diabetes, a disease that now accounts for 12 per cent of global healthcare spending. The Danish group has an unusually high exposure to the US market, but it is not alone in signaling tough times ahead. The chief executives of Novartis, Eli Lilly and GlaxoSmithKline have all warned recently that pricing will become increasingly challenging across the board. Accounting for 40 per cent of global drug sales, the fate of the US market is front and center in the minds of drug company executives, some of whom privately admit to preparing for a "confrontational" period in relations with politicians. Both Hillary Clinton and Donald Trump have suggested new measures to curb prices, including allowing imports from lower-cost countries, while individual US states, starting with Vermont, are working on transparency legislation that would require firms to disclose costs to justify drug prices. Novartis CEO Joe Jimenez believes drugmakers must develop value-for-money pricing models, like the performance-based deal the Swiss drugmaker recently struck with two US insurers for its new heart failure drug. Under that deal, payments for Novartis' Entresto pill are to be calculated in future based on the proven reduction in the proportion of the insurers' patients admitted to hospital for heart failure, not on the number of pills they consume. The aim is a flexible pricing system that rebates healthcare providers when a drug doesn’t work as planned and charges more when it works well. Europe in vanguard Europe is in the vanguard of such moves. Britain agreed an early performance-based deal for a Johnson & Johnson blood cancer drug back in 2007 and Italy also uses patient data to pay for cancer drugs based on actual patient responses. GSK CEO Andrew Witty sees this outcomes-based approach slowly becoming the norm in more disease areas and geographies. "Whoever wins the election in the US, and also in Europe, we will see those conversations play out over the next few years," he told Reuters. "I am not particularly expecting anything dramatic in 2017. I would say it is worth keeping an eye open for evolution of change, probably in ’18 and ’19." The pharmaceutical industry's European trade association is already discussing ways to shift to outcomes pricing, following price curbs in Germany that have caused some companies to pull products off the market, and effective rationing in Britain, where strict cost-effectiveness rules apply. Authorities in Asia's two biggest markets, China and Japan, are also intervening in new ways to cap runaway costs. Dani Saurymper, manager of the AXA Framlington Health fund, believes the issue is going to move up the agenda for investors, not least with the arrival of gene and cell therapies. These could cure diseases like haemophilia and certain cancers, but at a cost of hundreds of thousands or even $1 million a patient. "Pay for performance is going to become much more relevant," he said. Still, the obstacles are formidable. Drug companies and healthcare providers will need to work together to develop systems that capture and prove a medicine's clinical value, ideally using computerized systems that are only just emerging. There are also potential legal pitfalls, given the need to establish clear-cut clinical outcomes for patients and determine how much of an effect should be attributed to the medicine or other healthcare inputs. "Overall, it is the right direction but there are many practical difficulties," said Helen Roberts, a specialist in healthcare at law firm BonelliErede. "There may well be legal challenges if there is disagreement as to whether an outcome has actually been achieved." (Reuters)

Future of drug pricing: Paying for benefits not per pill

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