While the United States doesn’t have national health care, between Medicare and Medicaid, the government is funding the purchase of huge amounts of medications, more than enough to allow us to negotiate lower drug prices. The opposition to doing so has largely been about free market concerns, but if we had a free market, we wouldn’t also be funding a sizable amount of the country’s drug purchases.

The Trump administration’s Foreign First pricing approach doesn’t directly leverage that government buying power, instead it’s setting out to push large drug companies into matching comparable prices in some other unstated countries. Presumably western countries with nationalized health care and negotiating power.

It’s an end run around direct negotiations and we’ll see how effective it will be.

President Trump suggested that countries that “need extra help” will be excluded which means don’t expect drug prices to fall to the levels of African countries. And that means we’ll still be subsidizing much of the world.

Drug prices may fall somewhat, but since we’ll be largely competing with other Western or First World nations, drug companies will just use this as leverage to raise prices there, rather than lowering prices here.

To create meaningful change and get truly better rdeals, we need to leverage federal buying power to get better deals and we need to stop subsidizing drug prices for the rest of the world, not just Canada or the UK.