Trump expected to sign drug pricing executive orders Friday, angering pharma

White House aides spent much of Thursday fielding calls from drug company executives expressing frustration the administration is pushing the orders even as it pushes the industry — including awarding companies billions of dollars — to develop and manufacture vaccines for covid-19, the disease caused by coronavirus, according to a senior administration official and a Republican lobbyist.

Trump has regularly complained to advisers that drug prices are too high, and some of his political advisers see health care as a key vulnerability in 2020. Several polls have shown that voters trust Democrats more on health care. The executive orders are variations of drug pricing proposals the administration rolled out last year, according to the senior official and the lobbyist.

However, the orders are unlikely to take effect anytime soon, if they do so at all, since the power to implement drug pricing policy through executive order is limited. Voters will not see an impact before the November elections, and the drug industry is sure to challenge them in court.

One of the orders would speed up the timeline for a proposal the administration introduced late last year to allow states, drug wholesalers and pharmacies to import certain drugs from Canada. Drug companies have pushed back fiercely on that proposal, arguing there is “no way to guarantee the safety of drugs that come into the country from outside the United States’ gold-standard supply chain.”

Another would tie some Medicare drugs’ prices to those paid in other countries with significantly lower list prices — a so-called “international pricing index” or “most favored nations” clause. The idea is anathema to most congressional Republicans, who see it as price fixing, as well as to the pharmaceutical industry.

The third proposal is expected to require the provision of insulin and/or an EpiPen free through a program requiring pharmaceutical companies to provide steep discounts to thousands of hospitals and community health centers that serve large numbers of low-income patients. Drugmakers have targeted the program, known as 340B, arguing some facilities getting the discounts should not be eligible.

The White House declined to comment directly on the conversations with drug industry executives or the executive orders, but said the president was still looking at ways to lower drug prices.

“The President continues to explore any and all options that will deliver lower-cost drugs, while ensuring we have access to the most innovative vaccines and therapeutics in the world,” White House spokesman Judd Deere said in a statement.

White House Chief of Staff Mark Meadows has led the effort to turn previous administration proposals into executive orders the president could sign this summer, according to a senior administration official and two industry lobbyists who spoke on the condition of anonymity to discuss the plans. Several White House aides oppose the effort, arguing the administration should not alienate drug companies when it is so dependent on them for help ending the pandemic.