| |  | The Lead Brief | The White House is escalating its push to turn aspects of President Donald Trump’s drug pricing deals into law by courting the drug giants that could be bound by it. Administration officials held individual meetings with four major drugmakers — AstraZeneca, Bristol Myers Squibb, Eli Lilly and Merck — to show them draft legislative text that would codify key elements of Trump’s “most-favored-nation” (MFN) pricing policies, according to multiple people familiar with the meetings. I chatted with more than a half-dozen people about the push, all of whom spoke on the condition of anonymity to talk about the private discussions. Why it matters: With midterms approaching, Trump is leaning into drug pricing as a politically potent issue that he hopes could become a cornerstone of his health care legacy. Formalizing elements of the MFN pricing agreements — which compel companies to link their medicine prices in the United States to lower prices abroad — into statute could bring additional companies under the same pricing framework. The corporate meetings, which took place last Wednesday, are the first of several. Congressional Republicans have been lukewarm on the MFN codification push, some wary of what some see as government price controls, or unconvinced by the administration’s claims that industry is on board. Now, the White House appears to be trying to change that by bringing companies directly into the process. But the outreach may risk backfiring. The Trump administration cut MFN deals, which remain confidential, with 16 massive pharmaceutical manufacturers. Despite striking individual pricing agreements, most drugmakers haven’t rallied behind making them permanent. In fact, several people tell me certain companies believed making those deals would mean avoiding legislation altogether, leaving them frustrated by the current push to codify them. → The White House pushed back on the characterization that the separate meetings with drugmakers could help, as one person put it, “create the illusion that some companies could end in better favor than others” as a way for the administration to gain leverage when securing industry support. “In any situation, reading stakeholders into legislative action is not abnormal,” a White House official tells me. “There is no ulterior gamesmanship or strategizing beyond that. Most of these companies worked with us in very good faith, and we’re also working with them in good faith.” The draft bill itself is still a work in progress. Multiple people familiar with the meetings say companies were shown actual legislative text that would implement Trump’s MFN drug pricing priorities previously outlined in letters sent to drugmakers last year. Chris Klomp, who leads Medicare and oversees operations at the Department of Health and Human Services, said at a conference last week that the administration would be reaching out to drugmakers about codification to “see if they can buy in, if there’s a version we might reach,” according to Reuters. But the company names involved in the initial wave of meetings has not been reported. “Proposals under consideration are focused on ensuring Americans benefit from lower drug prices and aligning U.S. pricing more closely with international benchmarks where applicable,” an official at the Centers for Medicare and Medicaid Services told me Monday via email. “The agency does not comment on or speculate about potential future legislative actions.” Key details remain unclear, and the proposal could evolve significantly on Capitol Hill should lawmakers take it up. “It’s iterative,” said one person familiar with the meeting, regarding the legislative text. “It’s certainly not easy to draft the comprehensive ask they have on the table at the moment.” → It’s also unclear whether Republican lawmakers will line up behind the plan. Back in January, I reported in Health Brief that administration officials — including leaders from CMS — had met privately with GOP lawmakers and staff on the Senate Finance Committee, urging them to come up with their own text while offering to provide technical assistance. A spokesperson for the panel didn’t respond to an inquiry about the effort to codify the MFN policies. What to watch: Although passage of any legislation to implement Trump’s drug pricing initiatives is unlikely this year, opponents of the policies have an incentive to block the proposal from gaining any momentum for the longer term. | 
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