President Trump’s 2020 budget proposal is out, and it calls for a slew of cutbacks to science funding at NIH and the National Science Foundation, while offering to boost the coffers at the FDA. The plan now goes to a split Congress, likely to weigh in and significantly alter the White House’s blueprint.
Overall, the administration has proposed a roughly 12% cut to the HHS budget to $87.1 billion. The NIH budget has been culled even as it enhances the agency’s responsibility by advocating for publicly-funded R&D initiatives to end new HIV transmissions by 2030 and develop new treatments for pediatric cancer. To be sure, this White House has proposed cuts to the NIH for the last two years — but the agency enjoys bipartisan support in Congress and legislators will likely bat away any suggestions to shave the institute’s budget in the coming fiscal year.
Among the key propositions laid out included capping out-of-pocket costs for the elderly covered by Medicare, augmenting the FDA’s authority to crack down on drugmakers looking to thwart generic drug approvals and competition, and reform the 340B program by asking participating facilities to report how they are using savings.
Unsurprisingly, the budget also reiterated the White House’s focus on reining in drug prices, including empowering state governments to negotiate prices as part of their Medicaid budgets directly with manufacturers and shore up transparency so patients are not saddled with surprise bills.
“The proposed budget increases the drumbeat on drug pricing reform, and makes the possibility of either executive and/or legislative action increasingly likely,” Leerink Ana Gupte wrote in a note, suggesting that the proposal’s repeated focus on prices following the HHS proposal to eliminate drug manufacturer rebates indicates change is in the offing at the end of the comment period on April 8. “Our expectation that major change will be likely delayed to 2021 after the election.”
A crucial piece of proposed legislation was the imposition of $100 million in user fees for the e-cigarette industry, one that has frequently met the ire of outgoing FDA commissioner Scott Gottlieb, who has long admonished manufacturers for enticing youth into nicotine dependency with expertly marketed products. At the moment, these fees are limited to cigarettes, cigars and some other tobacco products. The funds will be used to develop a “regulatory framework for the appropriate oversight of e-cigarettes and in taking continued steps to reduce youth use of all tobacco products,” the FDA said in a separate statement on Monday.
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