The Congressional Budget Office scored the 2019 fiscal budget, and pharmaceutical companies don't have much to worry about.
At least that's the word from some analysts.
Updated from 7:12 a.m. with additional information.
Some concepts of the "drug pricing blueprint," the Trump administration's effort to get at the prickly issue of high prescription drug prices, were included in the budget released in February. And the CBO came out last week with an independent look at what those numbers entail.
"The specific proposals in February's White House budget constitute many (though not all) of the 'immediate actions' listed in the recent drug pricing blueprint and request for information, but the savings are relatively modest and would not present significant disruption for the industry," according to an investor note from Evercore ISI.
President Trump begs to differ. In a bill signing ceremony on Wednesday, May 30, Trump hinted that changes in drug pricing were on the horizon. "You're going to have some big news. I think we're going to have some of the big drug companies in two weeks said they're going to announce, because of what we did, they're going to announce voluntary massive drops in prices."
But as if often the case with the President's claims, he offered no proof with his statement and mentioned no drug companies by name to lend credence to what he told the crowd.
Though Trump campaigned on getting tough with the pharmaceutical industry over drug prices that many Americans feel are too high, since taking office, his bark has been far worse than his bite. On at least two occasions since he moved into the White House, Trump has said publicly that pharma companies are "getting away with murder." But in a speech earlier this month, Trump was light on policies that came directly at drug manufacturers.
Evercore ISI told clients its concern had more to do with policies that were more hypothetical. "The more important question for our coverage universe remains whether the administration follows through on threats categorized as 'further opportunities' to pursue something more disruptive to lower list prices, such as forcing gross-to-net spreads to narrow or moving completely away from the rebate system by revising the anti-kickback safe harbor (which CBO has not scored)," the firm wrote.
President Trump made a speech in the Rose Garden May 11 that was long on bluster and short on detail. Those who covered pharma largely saw it as a yawn. In a tweet the Jefferies trading desk called the speech benign.
But the speech was a jumping off point for the administration that has made multiple moves to shame drug companies into voluntarily lowering prices on its own.
Since launching its public campaign, the administration has had the Centers for Medicare and Medicaid Services redesign its Drug Spending Dashboards to include information on year-over-year drug pricing and who makes those medications so that consumers could see how drug prices have changed as well as linking drug companies to name brand drugs.
The administration has pledged to lower prices in part by getting generic drugs to market more quickly to help them compete directly with brand name drugs and hopefully lower prices for consumers. In a bid to help the public understand that some drug companies are gaming the system, the Food and Drug Administration posted a list of drug companies that it received complaints about interfering with generic drug companies trying to purchase name brand meds, so they could make generic copies. Generally generic companies need as many as 5,000 doses of a drug to submit testing information to the FDA towards generics approval.
The latest move by the administration is forming a working group at the FDA to figure out how to force pharmaceutical companies to include list prices for drugs in direct-to-consumer TV commercials. The thinking is that since drug companies spend so much on TV advertising ($3.45 billion last year), the inclusion of price might cause some companies to lower prescription charges.
Sandford Bernstein analysts Ronny Gal said in a published interview that he doesn't believe that the administration's efforts to shame pharmaceutical companies has caused much concern in the industry.
Health and Human Services Secretary Alex Azar remains undaunted. In public remarks a few days after Trump's speech, he promised more action. "We look forward to working with industry to build a better drug-pricing system. But if the industry isn't willing to work with us, President Trump and his administration will keep turning up the pressure."
Azar is set to appear on June 12 before the Senate Health, Education, Labor and Pensions Committee to make a pitch for congressional help. But it's an open question just how willing the House would be to help out on laws that might put pharmaceutical companies in the cross hairs, given that fact that many in Congress have received thousands of dollars in campaign support.
And with the midterms just six months out, many elected officials are already in campaign mode and less likely to want to get bogged down in what is likely to be a fight with pharma companies.