The Next President's Prescription for Action on Drugs: Obama and McCain Positions Similar-with One Major Difference.

and the profits of the pharmaceutical industry to trump good policy and the will of the American people,” Obama said on the floor of the Senate. John McCain did not vote that day, but in November 2003, as the House and Senate were adopting a conference agreement establishing the Part D program, he complained that providing an outpatient drug benefit to senior citizens without first getting drug costs under control was like “rearranging the deck chairs on the Titanic.” He expressly bemoaned the absence of a negotiation provision. He said: “Taxpayers should be able to expect Medicare, as a large purchaser of prescription drugs, to be able to derive some discount from its new market share. Instead, taxpayers will provide an estimated $13 billion a year in increased profits to the pharmaceutical industry.” Neither candidate has directly addressed formularies, much less P&T committees, either in the context of Part D reform or in their plans for providing health insurance to the currently un insured. McCain’s health insurance access proposal centers on eliminating the tax subsidies for employers to provide health insurance, instead giving individuals and families tax credits of $2,500 and $5,000 with which to purchase insurance in the private market. Mr. Obama would create a national insurance program, run by the federal government, that the uninsured could buy into if they preferred. Of course, every sector in the pharmaceutical industry— from manufacturers to wholesalers to pharmacy benefit management companies (PBMs) to retail and hospital pharmacies—supports the concept of universal health insurance. An expansion of access to health insurance would lift all boats in the pharmaceutical distribution chain, even though it might create some waves, too. Kevin J. Colgan, MA, RPh, FASHP, President of the American Society of Health-System Pharmacists and Senior Vice President of Health Economics and Outcomes Research at EPIQ, Inc., says: “I don’t have a preference for the Obama plan over the McCain plan. My preference is that we go about getting that taken care of.” Despite their frequent reference on the campaign trail to expanding access to health insurance, neither candidate would expect quick action on that priority upon election to the White House. But discussions between the new President and Congress are sure to get off the ground quickly. Charles Cote, Director of Public Affairs of the Pharmaceutical Care Management Association, has stated: “There is much more demand to get things done [for] the uninsured than 10 to 15 years ago.” Stephen Barlas is a freelance writer based in Washington, DC, who covers issues inside the Beltway.