美国总统特朗普签署四项行政命令，以降低美国处方药的高成本

美国总统特朗普表示，美国人购买处方药的费用，往往比德国、加拿大和其他国家购买一些最昂贵药品的费用还高出80%。周五特朗普签署了4项行政令旨在降低美国处方药的高成本，如果这些命令最终确定，美国的处方药市场将会有全面的改变。

第一道命令是针对高额的胰岛素价格，要求联邦社区医疗中心将他们在该药物和EpiPens上获得的折扣直接传递给患者。特朗普表示，这些供应商不应该在收取患者 "大量、全价 "费用的同时获得这些折扣。

第二项命令将允许各州、药店和批发商从加拿大进口药品，这些药品的价格通常低于美国。此前，根据食品和药物管理局的规定，在大多数情况下，从其他国家进口个人使用的药物是非法的。制药行业和监管机构也表示，进口药品可能会威胁到消费者的安全。但包括参议员Bernie Sanders在内的支持者则表示，从其他国家进口药品将增加竞争并大幅降低药物的价格。

第三项命令旨在防止“中间人”或药房福利经理（pharmacy benefit managers）获得“巨大折扣”。卫生与公共服务部部长Alex Azar表示，药品公司目前向中间商支付了约1500亿美元未公开的佣金，往往是为了换取更优惠的药品保险。新规定将要求这部分佣金用于老年人，使老年人的处方药成本降低约26％至30％，或每年降低300亿美元。

第四项命令是将特别允许联邦医疗保险（Medicare）实施所谓的 "国际定价指数"，也就是以与其他国家相同一致的价格购买药品。特朗普签署了第四个命令，但称可能不需要执行，目前暂时将其保留至8月24日，以便让该行业有时间提出一些建议来降低药品价格。并称，制药公司高管定于周二在白宫开会。

US President Trump stated that the cost of Americans buying prescription drugs is often 80% higher than the cost of buying some of the most expensive drugs in Germany, Canada and other countries. On Friday, Trump signed four executive orders aimed at reducing the high cost of prescription drugs in the United States. If these orders are finalized, the prescription drug market in the U.S. will undergo comprehensive changes.

The first order was for the high price of insulin, requiring the Federal Community Medical Center to pass on the discounts they received on the drug and EpiPens directly to patients. Trump stated that these providers should not receive these discounts while charging patients "massive, full-price".

The second order will allow states, pharmacies and wholesalers to import medicines from Canada, which are usually cheaper than the U.S.. Previously, according to the regulations of the Food and Drug Administration, in most cases, it was illegal to import drugs for personal use from other countries. The pharmaceutical industry and regulatory agencies also stated that imported medicines may threaten consumer safety. But supporters, including Senator Bernie Sanders, said that importing drugs from other countries would increase competition and significantly reduce drug prices.

The third order aims to prevent "middlemen" or pharmacy benefit managers from receiving "huge discounts." The Minister of Health and Human Services Alex Azar said that drug companies are currently paying about $150 billion in undisclosed commissions to middlemen, often in exchange for more favorable drug insurance. The new regulations will require this part of the commission to be used for the elderly, reducing the cost of prescription drugs for the elderly by about 26% to 30%, or $30 billion per year.

The fourth order will specifically allow Medicare to implement the so-called "international pricing index", that is, to purchase drugs at the same price as other countries. Trump signed the fourth order, but said it may not need to be implemented, and currently keep it until August 24 to allow the industry time to make some suggestions to reduce drug prices. It also stated that executives of pharmaceutical companies are scheduled to meet at the White House on Tuesday.  source

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