President Trump has pledged to take action to combat the opioid epidemic and reduce drug prices, but one year into his tenure, advocates and industry have grown skeptical of his promises.
During his State of the Union speech Tuesday, Trump said one of his top priorities is “fixing the injustice of high drug prices.”
When the new head of the Department of Health and Human Services was sworn in on Jan. 29, Trump said prescription drug prices would come “rocketing down.”
But advocates said they have heard it all before, and Trump has not acted on most of the drug pricing promises he made.
“No more words. Action. The clock is ticking,” David Mitchell, president of Patients for Affordable Drugs, said after Trump’s State of the Union address.
An administration official said Trump’s first State of the Union “made clear lowering drug prices and combating the opioid crisis are priorities for his administration. The President looks forward to ongoing work with his Cabinet, Congress and local leaders on the best path to tackle these issues.”
Trump’s tough talk on drug manufacturers dates back to his 2016 presidential campaign.
He promised to stand up to drug companies, and famously blasted the pharmaceutical industry as “getting away with murder” with steep drug prices.
During the campaign, he backed allowing Medicare to negotiate directly with drug companies, as well as to expand importation of cheaper medicine.
The pharmaceutical industry was worried. When Trump mentioned drug prices, stocks fell.
The industry’s top lobbying group, the Pharmaceutical Research and Manufacturers of America (PhRMA), increased its lobbying expenditures from $20 million in 2016 to $25.4 million in 2017.
The biggest jump in spending came in the first quarter of 2017, when Trump repeated his “getting away with murder” comment. PhRMA upped its lobbying expenditures by 35 percent, from $6 million in the first quarter of 2016 to $8 million in the first quarter of 2017.
But Trump has not mentioned those ideas since.
“I suppose that when it comes to Trump’s comments on high drug prices, he’s become the boy who cried wolf,” an industry lobbyist said.
Advocates are hopeful that Trump will support the Creating and Restoring Equal Access to Equivalent Samples (Creates) Act, legislation intended to prevent branded drug companies from using tactics to delay competition from cheaper generic drugs.
They said Trump supporting the Creates Act would be a good first start to putting action behind his words.
The bill has bipartisan support, and lobbyists and congressional sources think it could be added to a long-term government funding bill as a way to help pay for higher budget caps.
House Democrats, meanwhile, at first saw an opening to try to work with Trump on the drug pricing issue, but they say their overtures went nowhere.
“As I watched President Trump … try to claim with a straight face that he wants to work in a bipartisan way to lower drug prices, I was stunned by the complete and utter disconnect between his words and reality,” Rep. Elijah Cummings (D-Md.) said in a statement after the State of the Union.
“I have tried over and over and over to work with him … but all I have heard back is radio silence,” Cummings added. “These aren’t just empty promises, they are obvious falsehoods. I must keep up hope that the President will finally change course.”
The lobbyist said the pharmaceutical industry is worried about a potential Democratic takeover of Congress in 2019, given Trump’s stance on drug prices.
“Are we worried that Trump may potentially serve as an enable, rather than as a foil for Democratic policies aimed at hurting pharma companies? Absolutely,” the lobbyist wrote in an email. “He’s a wild card.”
Congressional Democrats and addiction advocates said they have also noticed a lack of significant administration action regarding the opioid crisis.
Trump declared the opioid epidemic a public health emergency in October, and renewed the declaration earlier this month. But he has not allocated additional resources to fight the epidemic.
A group of Senate Democrats, led by Health Committee ranking member Patty Murray (Wash.) and Elizabeth Warren (Mass.), this week asked the Government Accountability Office to investigate all the actions the administration has taken to combat the epidemic since declaring it a public health emergency.
During the State of the Union, Trump said the country must get “much tougher on drug dealers and pushers” to end the opioid epidemic, an approach that advocates disavow.
“We spent decades trying to get away from the narrative of the war on drugs,” said Andrew Kessler, a consultant at the advocacy group Slingshot Solutions. “Making the point about law enforcement … scares a lot of us. The war on drugs was an epic failure.”
An official White House commission earlier this year gave specific recommendations to the administration so it could address the opioid epidemic. During the State of the Union, Trump did not mention it.
“To have a commission work for a year, issue a report that’s stunningly comprehensive, and not mention it at all as part of the solution makes me wonder what the priorities of this White House are,” Kessler said.
After the recommendations were published, the White House released a statement commending the opioid commission, saying the administration “will continue to focus its resources to prevent new addictions from developing, and help those already suffering to recover from addiction.”
One advocate said his group is focusing its efforts on local agencies and the people who are on the ground on a daily basis, rather than the Trump administration.
“Will it be helpful if Trump and [White House counselor] Kellyanne Conway showed up and told us what their priorities are? Sure, but that’s not the way of the world right now,” said Jesse Heffernan of Faces and Voices of Recovery.
“Maybe we’ve become desensitized to thinking there’s going to be a bigger movement, so we’ll divert our energy to where we are being heard,” he added.