As Trump Prepares Plan to Lower Drug Prices, Big Pharma Girds for a Fight

A pharmacy in Deerfield Beach, Fla. Stung by a legislative defeat that required drug companies to lower prices for Medicare beneficiaries, the industry is pouring money into a lobbying campaign to thwart any serious efforts to rein in

WASHINGTON — In his State of the Union address in January and again in New Hampshire in March, President Trump made a bold promise: “You’ll be seeing drug prices falling very substantially in the not-too-distant future,” he said, “and it’s going to be beautiful.”

Not if the pharmaceutical companies can stop it.

Big Pharma is pouring money into a lobbying campaign to thwart any serious efforts to rein in prescription drug prices ahead of a presidential speech this month where Mr. Trump plans to lay out his drug pricing proposals.

“There is apprehension across the industry,” said Bruce Artim, who retired recently after 11 years as the director of federal affairs at Eli Lilly and Company. “Pharma folks are nervous.”

Drugmakers spent $171.5 million lobbying the federal government last year — more than insurance, electronics, oil and gas or any other industry, according to data compiled by the Center for Responsive Politics, an independent group that tracks money in politics.

Spending by the main lobby for the industry, the Pharmaceutical Research and Manufacturers of America, surged in the first quarter of this year, to $10 million, up from $8 million in the first quarter of last year and $6 million in the first quarter of 2016, the trade association said in reports filed with Congress. Its spending is on pace to top the annual totals it reported in recent years, $25.4 million in 2017 and $19.6 million in 2016.

Drug companies and their trade associations deployed 882 lobbyists last year, more than two-thirds of whom had previously worked for Congress or federal agencies, the center said.

And as Mr. Trump moves to flesh out one of his more popular campaign promises, drugmakers may have reason to mobilize. During the presidential campaign, Mr. Trump embraced positions on this issue long held by Democrats — and long opposed by his party and the pharmaceutical industry. He said, for example, that Medicare officials should negotiate prices with drug manufacturers, and that consumers should be allowed to import prescription drugs from Canada and certain other countries where brand-name drug prices are generally lower than in the United States.

The American people are likely to back him. A recent poll by the Kaiser Family Foundation found that 80 percent of Americans believe that drug costs are unreasonably high.

“The president’s concerns are born out of this populist impulse that we have to acknowledge: that patients are paying more for their health care, more for their medicine,” said Stephen J. Ubl, the president and chief executive of the Pharmaceutical Research and Manufacturers of America.

Efforts to attack the problem, even by the president, face stiff headwinds. The numbers bear out Mr. Trump’s statement that “pharma has a lot of lobbies and a lot of lobbyists and a lot of power.”

With its deep pockets and sophisticated lobbying, the drug industry has beaten back many efforts to reduce the payments it receives from Medicare, Medicaid and other government programs.

“Big Pharma has made a huge investment in Congress, with extensive lobbying and massive campaign contributions,” said Representative Lloyd Doggett, Democrat of Texas.

The Trump administration, like the Obama administration, has made clear that it wants to slow the growth of spending on drugs under Part B of Medicare, which covers many cancer drugs and other expensive medicines administered in doctors’ offices.

The reimbursement formula used in this part of Medicare creates “perverse incentives for prescribing higher-priced drugs” and discourages drug companies from competing on price, the White House Council of Economic Advisers said in a recent report.

Some of the alternatives being considered by the Trump administration, to inject competition into Part B of Medicare, have caused concern among drugmakers

Still, the industry is not immune. Drugmakers suffered a major setback in February when Congress required them to give deeper discounts to Medicare beneficiaries.

The action by Congress, which will cost drugmakers billions of dollars, “scared the bejesus out of them,” said Jayson S. Slotnik, a consultant to drug and medical device companies.

They are now worried about the proposals Mr. Trump may push to lower drug prices. Their anxiety is heightened by Mr. Trump’s unpredictability.

Drug company lobbyists say they are confident that Mr. Trump’s campaign ideas will not be endorsed by Alex M. Azar II, the secretary of health and human services, who used to work at Lilly, or Dr. Scott Gottlieb, the commissioner of the Food and Drug Administration, who was a frequent consultant to drug companies before he returned to government last year.