And he said he's prepared to use it.
"In place of the bold action he repeatedly promised voters during his campaign, this plan nibbles around the edges of cutting drug prices and fixing a broken drug market", Welch said.
"But if industry isn't willing to work with us to lower prices, President Trump and his administration will keep turning up the pressure - until the system finally puts American patients first".
And HHS will begin merging the part of the plan that covers doctor-administered drugs - known as Part B - with its prescription-drug benefit portion, or Part D, where private plans are able to negotiate down prices.
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Of the pharma giants, Johnson & Johnson's stock prices went up 0.9%, Pfizer Inc. gained 1.2%, UnitedHealth Group Inc. stocks rose 1.3% and Merck & Co.
Mr. Azar said the type direct negotiation that takes place in European countries would not work - and could be risky.
'We are going to take on one of the biggest obstacles to affordable medicine - the tangled web of special interest, ' he declared. According to this rule, pharmacists can not tell their customers if there are cheaper alternatives to the drugs they are buying without using their health plan. Instead, the companies would earn money only from the fees paid by the insurance companies or employers who hire them.
"Consumers would have much more balanced information, and companies would have a very different set of incentives for setting their prices", Azar added.
Sovaldi made by US-based Gilead Sciences in United States sells costs about USD 1000 per single pill, while in India - the generic version costs about four dollars.
Azar also said the Centers for Medicare and Medicaid Services would be updating a drug pricing database that will "offer much more detail than ever before about which companies are raising prices".
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Many Americans, especially seniors, face high out-of-pocket costs for the drugs they need.
Some are pretty technical, such as giving the Medicare Part D prescription drug program authority to negotiate lower prices for certain drugs under Medicare Part B. Others are more aspirational and politically controversial, such as Trump's broadsides against foreign countries that supposedly "free ride" by paying less money for drugs than Americans through their single payer systems. "The last thing we need is open borders for unsafe drugs in search of savings that can not be safely achieved", he said.
But analysts caution it could lead to higher out-of-pocket costs and less choice for patients. "Medicare gets a bill for the drug, composed of the standard price plus a 6% markup, and we pay it. Compare that with the negotiation in Part D: Plans determine whether a drug should be covered or whether an alternative is superior". In a call-in to the "Hugh Hewitt Show" on Monday morning, Azar suggested that moving Part B drugs into the Part D program could require legislation.
Mitchell and Levitt both doubt that drug companies can be shamed into lowering prices and losing profit.
"I think very expensive champagne will be popping in drug company boardrooms across the country tonight", said Democratic Representative Elijah Cummings.
Under Trump's CMS, the agency slashed $1.6 billion in payments to hospitals under the 340B drug discount program, which Republicans have attacked as growing beyond what Congress intended and research finding hospitals haven't used the discounts to help low-income patients.
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