Nan­cy Pelosi un­veiled the De­moc­rats’  drug pric­ing bill back in Sep­tem­ber and brought the fight straight to the in­dus­try with a pro­pos­al to em­pow­er the US gov­ern­ment to ne­go­ti­ate prices for se­lect drugs. Re­pub­li­cans, who de­cried the bill reeks of heavy-hand­ed gov­ern­ment in­ter­ven­tion which will sti­fle in­no­va­tion, now have a coun­ter­pro­pos­al they claim will re­sult in cheap­er drugs and in­cen­tivize R&D — fur­ther cloud­ing the prospects of a bi­par­ti­san com­pro­mise that could land on Don­ald Trump’s desk.

“On­ly one of these bills has the po­ten­tial to be­come law. While Speak­er Pelosi’s par­ti­san plan is dead on ar­rival in the Sen­ate and won’t be signed by Pres­i­dent Trump, H.R. 19 could be on Pres­i­dent Trump’s desk to­day,” said Re­pub­li­can Whip Steve Scalise in a state­ment on Mon­day. And in an ac­knowl­edg­ment that the Re­pub­li­can ef­fort would need Pelosi’s sign-off to reach a vote — a high­ly un­like­ly event — Scalise con­tin­ued, “Speak­er Pelosi must come to her sens­es. I am call­ing on her to bring H.R. 19 to the House floor for a vote this week. Amer­i­cans need a bi­par­ti­san so­lu­tion to pre­scrip­tion drug prices, not an­oth­er doomed pro­pos­al from the De­moc­rats.”

Re­pub­li­cans and De­moc­rats both ar­gue drug prices in the Unit­ed States are too high — the in­dus­try holds the crown for the least fa­vored sec­tor by Amer­i­cans, falling be­hind the fed­er­al gov­ern­ment it­self — but so far no­body can agree on just how to make the US health care sys­tem great again.

The 350-page Re­pub­li­can bill, HR19, pro­pos­es cre­at­ing the role of a ‘chief phar­ma­ceu­ti­cal ne­go­tia­tor’ at the Of­fice of the Unit­ed States Trade Rep­re­sen­ta­tive to ad­vo­cate on be­half of Amer­i­can pa­tients in trade agree­ments with re­spect to pre­scrip­tion drug prices.

In ad­di­tion, the bill seeks to lim­it an­nu­al out-of-pock­et costs for Medicare ben­e­fi­cia­ries at $3,100; caps the cost of in­sulin for se­niors in the Medicare Part D pro­gram; re­quires in­sur­ance com­pa­nies to make in­for­ma­tion about drug prices trans­par­ent at doc­tor’s of­fices so pa­tients are ap­prised of the po­ten­tial costs be­fore a pre­scrip­tion is writ­ten; and ‘stream­lines’ the reg­u­la­tion of over-the-counter prod­ucts.

Some of the pro­pos­als in HR19 al­so mir­ror poli­cies ad­vo­cat­ed by bi­par­ti­san leg­is­la­tion cur­rent­ly un­der con­sid­er­a­tion in the Sen­ate, in­clud­ing the CRE­ATES act which is de­signed to en­sure gener­ic drug­mak­ers can ac­cess brand­ed drugs to de­vel­op copy­cats, and pro­hibits “pay-for-de­lay” deals, where man­u­fac­tur­ers of brand­ed drugs main­tain their mo­nop­o­lies by of­fer­ing gener­ic com­pa­nies re­wards for de­lay­ing the launch of knock­off prod­ucts. 

The De­moc­rats’ drug pric­ing bill — HR 3, which is set to face a vote this week — could com­pel man­u­fac­tur­ers to com­ply with the prices set by the HHS, or face grave penal­ties and teth­ers the price of the some of the na­tion’s most ex­pen­sive drugs to an in­ter­na­tion­al price in­dex. Un­sur­pris­ing­ly, the bill — which promis­es to cut fed­er­al spend­ing by $345 bil­lion be­tween 2023 and 2029 — elicit­ed the ire of the in­dus­try that has so far thrived by tak­ing a lais­sez-faire ap­proach to pric­ing. Var­i­ous analy­ses have sug­gest­ed the bill, which is un­like­ly to be signed in­to law, could re­sult in be­tween 8 to 100 few­er drugs from reach­ing the mar­ket over the next decade.

A raft of Re­pub­li­can law­mak­ers is­sued state­ments sup­port­ing HR19 on Mon­day, sug­gest­ing not on­ly is HR19 su­pe­ri­or to HR3, but is far more like­ly to be signed in­to law.

“This (bill) con­tains mea­sures with bi­par­ti­san sup­port in the House and Sen­ate, can be­come law, and de­serves a vote. Mean­while, Speak­er Pelosi’s par­ti­san drug pric­ing scheme is not on­ly bad pol­i­cy, it’s nev­er go­ing to be­come law,” said the ar­chi­tects of HR19, Kevin Brady, the se­nior Re­pub­li­can on the pow­er­ful Ways and Means Com­mit­tee, along with Greg Walden (R-OR) and Vir­ginia Foxx (R-NC).

That may well be the case — the White House last week is­sued a scathing re­view of HR3, ac­cus­ing the Pelosi bill of fa­vor­ing short-term sav­ings over the “long-term cost of Amer­i­can pa­tients los­ing ac­cess to new life­sav­ing treat­ments.” But with De­moc­rats firm­ly in charge of the House of Rep­re­sen­ta­tives, HR19 faces a sim­i­lar­ly quixot­ic road to Trump’s desk, with ar­ti­cles of im­peach­ment threat­en­ing to over­shad­ow the po­lit­i­cal cal­en­dar.

→ PIC Therapeutics hasn’t raised much money, yet. But the fledgling biotech has attracted a high-profile player to the helm.

The Boston-based biotech has handed the reins to Katherine Bowdish as its president and CEO. Bowdish will also join the board of directors of PIC. Bowdish joins from Sanofi where she served as VP and head of R&D strategy, as well as helping launch and lead Sanofi Sunrise, a venture investment and partnering vehicle at Sanofi. Before that, Bowdish held several exec roles at Permeon Biologics, Anaphore, Alexion Pharmaceuticals and Prolifaron (acquired by Alexion).

Martin Shkreli didn’t just blog, read up on drug development news and run his biotech business with a contraband cell phone in prison. According to the FTC, he was also coordinating the anticompetitive scheme to shield Daraprim — the drug at the center of a price-gouging controversy that earned him the “Pharma Bro” nickname — from generic rivals.

Back in January the FTC, together with New York’s attorney general, launched a federal lawsuit against Shkreli, who’s now serving a 7-year sentence for defrauding investors in his hedge fund, alleging that he effectively created a drug monopoly. While Shkreli’s notorious move to raise the per tablet price of Daraprim from $17.50 to $750 was perfectly legal, the tactics he allegedly deployed to box out competitors weren’t.