Former President Donald Trump and Vice President Kamala Harris have agreed on a uncommon level of their in any other case bitter and divisive battle: it’s as much as the federal government to decrease excessive U.S. drug costs.

Harris solid the tie-breaking vote within the Senate in 2022 for laws permitting Medicare to barter drug costs for its greater than 60 million beneficiaries. Earlier than that, she was an aggressive regulator of the pharmaceutical business as California’s legal professional normal.

As president, Trump would probably proceed negotiating Medicare costs except the pharmaceutical business comes up with one thing extra compelling, individuals near him say. In his first time period, he proposed a number of insurance policies geared toward decreasing prescription prices, however their implementation had restricted success.

Nonetheless, the pharmaceutical business may gain advantage if Trump fails to implement such proposals.

“His efforts have been largely fragmented and confronted resistance from each business and lawmakers,” stated Sergio Jose Gutierrez, a political strategist who has labored primarily with Democrats within the U.S. “The shortage of a coherent technique and restricted capability to implement significant change made his strategy much less efficient in comparison with what a Harris-Walz administration may ship.”

The business has come beneath rising assault from lawmakers in each events over drug costs that the majority Individuals contemplate unreasonable, in keeping with KFF polls, so the election final result may very well be essential to the destiny of pharmaceutical corporations. Their plight is a pointy reversal from earlier years, when the businesses had a fame as almost untouchable. For greater than a decade, producers efficiently fended off proposals to let Medicare negotiate decrease drug costs earlier than dropping the battle two years in the past.

The shift of their political stance is seen in drug corporations’ contributions to candidates. An business that gave three to 4 occasions as a lot to GOP candidates because it did to Democrats within the Nineteen Nineties and early 2000s is now hedging its bets. Up to now within the 2024 cycle, drug corporations have given $4.89 million to Democrats and $4.35 million to Republicans, in keeping with OpenSecrets, an impartial analysis group.

Harris obtained $518,571 from the business and Trump obtained $204,748.

On the Democratic Nationwide Conference in Chicago final week, Harris and fellow Democrats touted their achievements in decreasing drug costs. Harris supporters level to her previous and current.

When she was California's legal professional normal, she was concerned in circumstances that resulted in almost $7.2 billion in fines (about $22 per particular person within the U.S.) for pharmaceutical corporations.

Her vote to go President Joe Biden's Inflation Discount Act not solely cleared the best way for Medicare value negotiations, but in addition for a $2,000 annual cap on Medicare beneficiaries' whole drug spending and a $35 cap on their month-to-month insulin provides.

“In the USA of America, no senior citizen ought to have to decide on between getting their prescriptions crammed or paying their hire,” Harris stated on August 15 throughout her first joint look with Biden since he withdrew from the presidential race.

She has pledged to increase each the annual cap on drug spending and the cap on insulin costs to all Individuals with insurance coverage, not simply these with Medicare, if she is elected president.

Harris additionally supported a controversial coverage that will give the federal authorities the authority in some circumstances to deliver extra competitors into the market by seizing patents on sure costly medicine developed with federal funds.

Doug Hart, 77, of Tempe, Arizona, spends about $7,000 a 12 months on pharmaceuticals. A drug he takes to forestall blood clots will price much less beneath Medicare value negotiations. The retired union president stated the drop might be important and is one purpose he helps Harris.

“The Republicans all voted in opposition to Medicare negotiations. Harris broke the tie within the Senate to permit it,” stated Hart, who’s a board member of the Arizona Alliance for Retired Individuals, which works to mobilize returning union members and activists for progressive points.

Whereas Republicans as a celebration are friendlier to the pharmaceutical business, Trump is keen to problem GOP orthodoxy by taking motion to fight the excessive price of medicine.

Throughout his administration, he tried to tie Medicare drug costs to decrease worldwide costs, a proposal that the PricewaterhouseCoopers Well being Analysis Institute estimated would price 5 drugmakers as a lot as $500 million a 12 months. What was referred to as the “most favored nation” interim remaining rule was blocked by authorized challenges and later rescinded by the Biden administration.

Trump has issued a rule that creates a path for the import of medicines from Canada and different international locations, with Florida this 12 months turning into the primary state to obtain federal approval to import some pharmaceuticals from Canada. However the state has been dogged by opposition from Well being Canada, the Canadian authorities division answerable for nationwide well being coverage.

And on his marketing campaign web site, Trump posted a video questioning whether or not well being issues in youngsters are the results of “overprescribing” medicine.

“Too typically, our public well being system is just too near Huge Pharma — they make some huge cash, Huge Pharma — massive companies and different particular pursuits, they usually don’t wish to ask the exhausting questions on what’s taking place to our youngsters’s well being,” he stated. “When Huge Pharma is ripping off American sufferers and taxpayers or placing income earlier than individuals, they have to be investigated and held accountable.”

Trump has not stated a lot about drug costs throughout his 2024 marketing campaign, however allies and former advisers say he’s nonetheless dedicated to decreasing drug costs if re-elected.

He would probably deal with rising competitors from generics and biosimilars, importing medicine made within the U.S. however bought overseas, and capping the price of out-of-pocket insulin, former Trump administration officers stated. Different objectives may embody decreasing drug costs within the Medicare 340B program, which requires drugmakers to offer outpatient drugs at lowered costs to eligible well being organizations that serve lower-income sufferers with out insurance coverage.

“The primary challenge that he was involved about once I was within the White Home, and that I nonetheless hear him discuss, is decreasing drug costs,” stated Theo Merkel, a senior analysis fellow at conservative suppose tanks Paragon Well being Institute and the Manhattan Institute. Merkel additionally served as a particular assistant within the Trump White Home. “I’m assured that might be on the high of the agenda,” he added.

Catherine Hill, spokeswoman for the Pharmaceutical Analysis and Producers of America (Phrma), stated the commerce affiliation seems to be ahead to working with any future presidential administration.

She criticized the Biden administration’s plan for Medicare value negotiations and Trump’s plan to align U.S. costs with these overseas. This month, the administration introduced new, lowered costs for 10 medicine in this system after negotiations between the federal authorities and pharmaceutical corporations. The decrease prices will go into impact in 2026.

“Earlier value controls enacted by the Biden administration threaten to stifle that innovation,” Hill stated. “Erasing mental property protections and borrowing value controls from different international locations will additional undermine innovation and threaten affected person entry to medicines.”

KFF Well being Information is a nationwide newsroom producing in-depth journalism on well being points and is among the key operational packages at KFF, an impartial supply of well being coverage analysis, polling and journalism. Study extra about KFF.