Harris said Trump ‘never' kept his promise on prescription drug price negotiations. That's True.

Since Vice President Kamala Harris entered the presidential race, she and former President Donald Trump have sparred over their approaches to lowering prescription drug costs. Harris has described this as an important campaign promise that Trump made but didn’t deliver. 

"Donald Trump said he was going to allow Medicare to negotiate drug prices," Harris said during the ABC News debate on Sept.10 in Philadelphia. "He never did. We did." 

She previously told CNN that Trump’s promise to pursue such negotiations "never happened" during his administration.

During the 2016 presidential campaign, Trump repeatedly promised, if elected, to take steps to allow the government to negotiate drug prices. He never enacted such a policy in office. The Trump administration pursued smaller, temporary programs aimed at lowering drug costs. 

However, experts say the effect of Trump’s moves fell far short of the expected effect of the Medicare drug price program included in President Joe Biden’s Inflation Reduction Act or of what Trump promised.

The Inflation Reduction Act — a sweeping climate and health care law Biden signed in August 2022 — included a measure authorizing the Centers for Medicare and Medicaid Services to negotiate Medicare’s prescription drug prices directly with pharmaceutical companies. 

"The idea behind drug price negotiation is that Medicare can use its buying power to get a better price than what is currently being negotiated for these drugs," according to Juliette Cubanski, deputy director of the program on Medicare policy at KFF, a health information nonprofit that includes KFF Health News. 

Medicare covers more than 66 million Americans,  giving it enormous potential influence over prices for U.S. drugs and medical services.

In August, the Centers for Medicare and Medicaid Services announced it had secured significant discounts on the list prices of 10 drugs because of its negotiations. Those discounts ranged from a 38% reduction in cost for blood cancer medication Imbruvica on the low end to a 79% cut for diabetes drug Januvia on the high side. (List prices and the prices Medicare drug plans pay can differ.)

The new prices are expected to save Medicare $6 billion in the first year, with Medicare beneficiaries set to save another $1.5 billion in out-of-pocket costs, according to the White House. 

Those new prices aren’t set to take effect until 2026 — though Biden and Harris have highlighted other aspects of the law that are bringing down drug costs sooner, such as a $35-per-month out-of-pocket price cap on insulin for Medicare enrollees and a $2,000 yearly out-of-pocket spending cap for Part D drugs effective in January. The Part D program covers most generic and brand-name outpatient prescription drugs. 

The Centers for Medicare and Medicaid Services will start negotiating prices for the next group of drugs — 15 per year for the next two years — in early 2025, and those talks will continue annually through the end of the decade.

As a presidential candidate in 2016, Donald Trump pledged to pursue prescription drug negotiation programs — and sometimes overstating such a policy’s power to cut prices.

During multiple campaign rallies and media interviews that year, Trump suggested allowing the government to negotiate drug prices directly with manufacturers would save upwards of $300 billion per year, a claim fact-checkers said was "absurd" then.

"The problem is, we don't negotiate," Trump said during an MSNBC town hall in Charleston, South Carolina, on Feb. 17, 2016. "We're the largest drug buyer in the world. We don't negotiate." He went on to say: "If we negotiated the price of drugs, Joe, we'd save $300 billion a year." 

Similarly, at a February 24, 2016, rally in Virginia Beach, Virginia, Trump reiterated his interest in making this change. "If you bid them out we'll save $300 billion … and we don't even do it. We're going to do it." The pharmaceutical industry would push back, he said, but added: "Trust me I can do it."

In office, however, Trump backed away from those promises, rejecting a bill then-House Speaker Nancy Pelosi, D-Calif., had proposed to authorize such negotiations. The Democratic-led House ultimately passed that legislation, though the Republican-led Senate didn’t consider it.

"Pelosi and her Do Nothing Democrats drug pricing bill doesn’t do the trick," Trump wrote on Twitter. 

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Trump pursued smaller initiatives that sought to lower drug costs. One such program, the Most Favored Nation Model, tried to cap the cost of some Part B medications — those administered in a doctor’s office or hospital — at the lowest price paid in other peer nations (countries with a per-capita GDP of at least 60% of the U.S.’s). 

"Medicare is the largest purchaser of drugs anywhere in the world by far," Trump said in announcing the program. "We’re finally going to use that incredible power to achieve a fairer and lower price for everyone."

The Trump campaign didn’t respond to an inquiry about prescription drug negotiations or the Most Favored Nations model.

The program would have started in January of 2021 and lasted for seven years. Centers for Medicare and Medicaid Services officials estimated the government would save more than $85 billion on Part B spending. But some of those savings came from assumptions that Medicare beneficiaries would lose access to some Part B medications under the model, with some manufacturers unlikely to sell products at the lower, foreign prices.

Trump’s program never took effect. Amid lawsuits from several drug companies and industry groups, a federal judge stayed the plan in December 2020. The Biden administration scrapped it in 2022.

Even if the Most Favored Nation model had been enacted, experts say it wouldn’t have come close to saving Americans or the government as much money as the IRA’s drug negotiations provisions. A contemporaneous analysis of Trump’s program estimated that 7% of the 60 million Medicare beneficiaries in 2018 would have benefited. 

More importantly, the Most Favored Nation model did not authorize the government to negotiate prescription drug prices with manufacturers — the policy Trump promised to implement. 

As a presidential candidate in 2016, Donald Trump promised to let the government negotiate prescription drug prices directly with pharmaceutical companies. As president, however, he instead tried to tie some U.S. drug prices to their costs in other countries. Drugmakers and industry groups sued, challenging the move, and courts blocked it.

Harris, therefore, is correct that Trump never was able to open Medicare up to drug negotiations despite his sweeping campaign promises.

We rate Harris’ claim True. 

CORRECTION, OCT. 1: This story was updated to correct the following quote attributed to Trump: "If you bid them out we'll save $300 billion."